Predictors of Successful Antibiotic Treatment of Osteomyelitis in Diabetic Forefoot Infection.

Background: Osteomyelitis (OM) associated with diabetic foot ulceration (DFU) is a growing public health challenge worldwide. Since 2012 the number of patients presenting with DFU per year to our centre has doubled.

Objective: This study aims to evaluate outcomes from outpatient antibiotic therapy (OPAT) in the management of OM in DFU patients.

Treatment of Post Neck Radiation Carotid Blowout Syndrome with Viabahn Stent Placement.

Carotid blowout syndrome (CBS) is a critical and often fatal complication associated with head and neck malignancies. CBS is characterized by 3 stages as follows: threatened, impending, and acute rupture or hemorrhage. The condition is notably linked with a history of radiotherapy for head and neck cancers, with an incidence of approximately 3-4% among those who have received such treatments.

Large-scale interactions in predictive processing: oscillatory versus transient dynamics.

How do the two main types of neural dynamics, aperiodic transients and oscillations, contribute to the interactions between feedforward (FF) and feedback (FB) pathways in sensory inference and predictive processing? We discuss three theoretical perspectives. First, we critically evaluate the theory that gamma and alpha/beta rhythms play a role in classic hierarchical predictive coding (HPC) by mediating FF and FB communication, respectively. Second, we outline an alternative functional model in which rapid sensory inference is mediated by aperiodic transients, whereas oscillations contribute to the stabilization of neural representations over time and plasticity processes.

Epistaxis Rates and Health Care Utilization in Patients With a Ventricular Assist Device.

Objective: Identify baseline epistaxis rates and epistaxis-related health care utilization trends in the ventricular assist device (VAD) population.

Methods: Single center, retrospective cohort study consisting of chart review of adult VAD patients. Analysis of descriptive statistics was assessed using tests, independent sample tests, or Fisher's exact when expected counts were low.

Chondronecrosis of the cricoid treated with hyperbaric oxygen therapy: A case series.

We present two cases of cricoid chondronecrosis treated with hyperbaric oxygen (HBO) therapy. Both patients presented with biphasic stridor and dyspnea several weeks after an intubation event. Tracheostomy was ultimately performed for airway protection, followed by antibiotic treatment and outpatient HBO therapy.

Rural-urban otolaryngologic observational workforce analysis: The state of Nebraska.

Objective: To analyze the rural-urban access to otolaryngology (OHNS) care within the state of Nebraska.

Design: Cross-sectional study.

Methods: Counties in Nebraska were categorized into rural versus urban status based upon the 2013 National Center for Health Statistics urban-rural classification scheme with I indicating most urban and VI indicating most rural.

The Multimodal Diagnostic Approach Necessary in Detecting Elusive Submucosal Laryngeal Cancer.

Submucosal laryngeal lesions have proven themselves to be a diagnostic challenge in the field of medicine, often presenting inconsistently between endoscopic visualization, various imaging modalities, and biopsy. The conflicting clinical picture can lead to a delay in definitive diagnosis and treatment. A variety of laryngeal imaging modalities exist that give a unique perspective of the tumor being evaluated and can be used in combination to clarify discrepancies in presentation.

Attentional modulation of inter-areal coherence explained by frequency shifts.

Inter-areal coherence has been hypothesized as a mechanism for inter-areal communication. Indeed, empirical studies have observed an increase in inter-areal coherence with attention. Yet, the mechanisms underlying changes in coherence remain largely unknown.

Quality Versus Quantity: Using Scholarly Activity to Assess Otolaryngology Residency Candidates.

Selecting qualified candidates each year for residency positions has become more difficult in recent years, due to the sharp increase in Otolaryngology applicants. Although there are objective measures that can be used to directly compare medical students during the initial screening process, most information in the application is highly subjective and/or variable across institutions. Many programs count the total posters/presentations and publications to gauge scholarship.

Coherence fails to reliably capture inter-areal interactions in bidirectional neural systems with transmission delays.

Accurately measuring and quantifying the underlying interactions between brain areas is crucial for understanding the flow of information in the brain. Of particular interest in the field of electrophysiology is the analysis and characterization of the spectral properties of these interactions. Coherence and Granger-Geweke causality are well-established, commonly used methods for quantifying inter-areal interactions, and are thought to reflect the strength of inter-areal interactions.

Transcervical intubation for massive self-inflicted neck wound transecting the epiglottis.

Background: Penetrating trauma to the larynx is a rare phenomenon with a high risk of mortality and morbidity due to the density of vital structures in the area (Demetriades et al., 1996). Most commonly, this type of injury is due to a gunshot wound or knife injury (Snow and Ballenger, 2003).

Paediatric eating disorders: Exploring virtual family therapy during a global pandemic.

Aim: Explore treatment response and effectiveness of virtual treatment for a paediatric eating disorder sample.

Methods: Twenty patients and their families who received either virtual or in-person family therapy were included in the study. Family therapy was informed by family-based treatment (FBT) principles.

Reliability of the modified Frailty Index (mFI) for intervention and continued surveillance in elective infrarenal abdominal aortic aneurysm (AAA).

Introduction: Frailty has been proven to lead to higher morbidity and mortality rates in surgical patients, independent of age. The modified Frailty Index (mFI) is a validated means of assessing for frailty.

Aim Of Study: The aim of this study is to ascertain if the mFI correlates with clinician experience in turning down patients for abdominal aortic aneurysm (AAA) surgery and/or AAA surveillance.

Recurrent Lingual Abscess in an Elderly Female With Bulbar Amyotrophic Lateral Sclerosis.

A  is a rare condition that was scarcely described in clinical textbooks. A lingual abscess recurrence is rare and has only been described twice in the literature. Typically, the tongue and oral cavity have multiple intrinsic properties which stave off intralingual infection; however, there may be situations in which these properties are compromised, as demonstrated in oro-motor disability.

Quantifying rhythmicity in perceptual reports.

Several recent studies investigated the rhythmic nature of cognitive processes that lead to perception and behavioral report. These studies used different methods, and there has not yet been an agreement on a general standard. Here, we present a way to test and quantitatively compare these methods.

Traumatic open brachial plexus injuries: The importance of interdisciplinary collaboration.

Open traumatic brachial plexus injuries are rare, yet can be life threatening and require rapid clinic assessment. Early interdisciplinary collaboration is critical to achieve superior patient outcomes. This case of a 24-year-old female of a traumatic neck injury with contralateral brachial plexus injury demonstrates the limitations of early clinical assessment due to the potential for haemodynamic instability and highlights the priority of patient stabilisation.

Spontaneous variability in gamma dynamics described by a damped harmonic oscillator driven by noise.

Circuits of excitatory and inhibitory neurons generate gamma-rhythmic activity (30-80 Hz). Gamma-cycles show spontaneous variability in amplitude and duration. To investigate the mechanisms underlying this variability, we recorded local-field-potentials (LFPs) and spikes from awake macaque V1.

Establishment of a clinical nurse specialist-led, virtual aneurysm surveillance clinic.

Background: The COVID-19 pandemic has necessitated significant changes to the manner in which healthcare is delivered. Chief among these has been the need to rapidly adopt virtual, or telephone clinics as a means of reducing unnecessary patient exposure to hospitals and clinical care settings. We were greatly aided in our adoption of virtual clinics by our experience in the establishment and maintenance of a Clinical Nurse Specialist-led, virtual clinic for both abdominal aortic (AAA) and extra-aortic aneurysm (EAA) surveillance within our department since 2016.

Development of a coordinated acute diabetic foot pathway for management of acute diabetic foot infection and ulceration.

Background: Diabetic foot ulceration (DFU) has become an increasingly common emergency presentation. These patients are presenting at a younger age and with increasingly complex co-morbidities. They require frequent hospitalisation for management of DFU which has significant consequences for management of health resources but also for quality of life in the diabetic patient population.

Integrated Comprehensive Care for Transcare and Gender Diverse Clinic Patients: An Assessment of Physical, Mental, and Social Needs.

Introduction There is a large body of research reporting the healthcare needs of groups identifying as lesbian, gay, bisexual, transgender, and/or queer (LGBTQ); however, a gap exists in the research literature because many epidemiological studies focus on sexual orientation rather than gender identify/incongruence. To address the lack of specific data from transgender and gender diverse (TGD) individuals, our organization designed and deployed a survey to assess the gender-affirming physical, mental, and social care needs of current patients. Methods A group of subspecialty physicians currently working with TGD patients created a list of questions and requested feedback from medical professionals familiar with the healthcare needs of this population.

Stimulus-specific plasticity of macaque V1 spike rates and gamma.

When a visual stimulus is repeated, average neuronal responses typically decrease, yet they might maintain or even increase their impact through increased synchronization. Previous work has found that many repetitions of a grating lead to increasing gamma-band synchronization. Here, we show in awake macaque area V1 that both repetition-related reductions in firing rate and increases in gamma are specific to the repeated stimulus.

Just-In-Time Simulation Training for Nasopharyngeal Specimen Collection During the SARS-CoV-2 Pandemic.

Introduction: Rapid and accurate detection of the novel coronavirus using a nasopharyngeal specimen requires training for professionals who may have limited experience. To respond to the urgent need, an interprofessional team created a just-in-time (JIT) module to provide only what was needed, precisely when needed, and rapidly deployed training sessions to a large group of health professionals.

Methods: In April and May 2020, health professionals from the hospital, ambulatory clinics, and public health attended training.

A Novel Just-In-Time-Online-Training for Nasopharyngeal Swab Specimen Collection During the COVID-19 Pandemic.

Introduction:  The spread of coronavirus disease 2019 (COVID-19) is controlled by timely detection of infected patients using a nasopharyngeal (NP) swab test, followed by isolation and treatment. One challenge encountered with NP swab collection was to train healthcare providers (HCPs) with different training backgrounds and experience for collecting NP swab specimens across Nebraska, including a sizeable rural area. In-person training for NP swab collection skills was challenging due to social distancing.

Clinical outcomes from profundoplasty performed as a sole procedure for revascularization in critically ischaemic limbs.

Objectives: The aim of this study is to investigate the durability and clinical efficacy of profundoplasty as a sole procedure in patients presenting with critical limb ischaemia associated with profunda femoral artery disease and superficial femoral artery occlusion.

Methods: Retrospective analysis of outcomes from all patients who underwent surgical profundoplasty in a single tertiary referral centre was performed. Patients who presented with either rest pain or tissue loss and had combined profunda femoral artery disease and superficial femoral artery occlusion were included in the study.