Investigating the Effect of Blurring and Focusing Current in Cochlear Implant Users with the Panoramic ECAP Method.

Purpose: For some cochlear implants (CIs), it is possible to focus electrical stimulation by partially returning current from the active electrode to nearby, intra-cochlear electrodes (partial tripolar (pTP) stimulation). Another method achieves the opposite: "blurring" by stimulating multiple electrodes simultaneously. The Panoramic ECAP (PECAP) method provides a platform to investigate their effects in detail by measuring electrically evoked compound action potentials and estimating current spread and neural responsiveness along the length of the CI electrode array.

Canopy dieback and recovery in Australian native forests following extreme drought.

In 2019, south-eastern Australia experienced its driest and hottest year on record, resulting in massive canopy dieback events in eucalypt dominated forests. A subsequent period of high precipitation in 2020 provided a rare opportunity to quantify the impacts of extreme drought and consequent recovery. We quantified canopy health and hydraulic impairment (native percent loss of hydraulic conductivity, PLC) of 18 native tree species growing at 15 sites that were heavily impacted by the drought both during and 8-10 months after the drought.

Fix and replace: Simultaneous fracture fixation and hip replacement for acetabular fractures in older patients.

Introduction: Displaced acetabular fractures in the elderly present significant treatment challenges. The 'fix and replace' concept involves open reduction and internal fixation of the acetabulum, providing bony stability to accept the press-fit of an acetabular cup, with a cemented femoral stem. This allows early mobilisation and the advantages this confers.

Sentinel lymph node biopsy for early oral cancer - accuracy and considerations in patient selection.

Sentinel lymph node biopsy (SLNB) for staging oral squamous cell carcinoma (OSCC) patients presenting with early (T1 and T2 N0) disease in preference to elective neck dissection (END) remains controversial worldwide. A retrospective analysis of 145 patients who underwent sentinel lymph node biopsy for a previously untreated early oral cancer between 2010 and 2020 was performed. The primary outcome measures were predictors of occult metastases, accuracy of SLNB and disease specific plus overall survival.

Applying the British Association of Oral and Maxillofacial Surgeons quality outcomes metrics to a UK oncology and reconstructive surgery service - benchmarking the data.

The British Association of Oral and Maxillofacial Surgery is soon to implement the Quality Outcomes in Oral in Maxillofacial Surgery (QOMS) to provide a platform for quality management across the specialty in the UK. The initial oncology and reconstruction audits for QOMS involves data collection on specific procedures and metrics. The aim of this report is to determine their appropriateness using extant audit datasets in our institution that overlap substantially with the QOMS audits.

Postoperative delirium in patients with head and neck oral cancer in the West of Scotland.

Our aims were to determine the prevalence and association of postoperative delirium (POD) in head and neck (H&N) cancer patients undergoing free flap reconstruction at the oral and maxillofacial surgery (OMFS) unit, Queen Elizabeth University Hospital (QEUH) Glasgow, and to assess whether these determinants can be modified to optimise patient care and reduce the occurrence of POD. Delirium remains an important problem in the postoperative care of patients undergoing major H&N surgery, and early detection and management improve overall outcomes. The patient database containing details of the preoperative physical status (including alcohol misuse, chronic comorbidity, and physiological status) of 1006 patients who underwent major H&N surgery with free-flap repair at the QEUH from 2009-2019, was analysed.

Nationwide randomised trial evaluating elective neck dissection for early stage oral cancer (SEND study) with meta-analysis and concurrent real-world cohort.

Background: Guidelines remain unclear over whether patients with early stage oral cancer without overt neck disease benefit from upfront elective neck dissection (END), particularly those with the smallest tumours.

Methods: We conducted a randomised trial of patients with stage T1/T2 N0 disease, who had their mouth tumour resected either with or without END. Data were also collected from a concurrent cohort of patients who had their preferred surgery.

Is the 8th edition of the Union for International Cancer Control staging of oral cancer good enough?

Depth of invasion is an important predictor of survival. A study by the International Consortium (ICOR) for Outcome Research proposed incorporation of it (together with the greatest surface dimension, or the anatomical criteria, or both) into the T stage. This has been adopted in part by the 8th edition of the Union for International Cancer Control (UICC) TNM 8 classification of malignant tumours for oral squamous cell carcinoma (SCC).

The effect of bearing surface on risk of periprosthetic joint infection in total hip arthroplasty: a systematic review and meta-analysis.

Aims: Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Different bearing surface materials have different surface properties and it has been suggested that the choice of bearing surface may influence the risk of PJI after THA. The objective of this meta-analysis was to compare the rate of PJI between metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), and ceramic-on-ceramic (CoC) bearings.

REHEARSAL Using Patient-Specific Simulation to Improve Endovascular Efficiency.

Objective: To determine whether rehearsal using patient-specific information loaded onto an endovascular simulator prior to carotid stenting improves procedural efficiency and outcomes.

Methods: Patients scheduled for carotid artery stenting who had adequate preoperative computed tomography (CT) imaging were considered for enrollment. After obtaining informed consent, patients were randomized to control versus rehearsal groups.

Antimicrobial photodynamic therapy-a promising treatment for prosthetic joint infections.

Periprosthetic joint infection (PJI) is associated with high patient morbidity and a large financial cost. This study investigated Photodynamic Therapy (PDT) as a means of eradicating bacteria that cause PJI, using a laser with a 665-nm wavelength and methylene blue (MB) as the photosensitizer. The effectiveness of MB concentration on the growth inhibition of methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Pseudomonas aeruginosa and Acinetobacter baumannii was investigated.

Successful Use of Nellix and Endovascular Aortic Sealing Technology for Treatment of Aortic Rupture in a Porcine Model.

Background: Endovascular aortic sealing (EVAS) represents a recent transformation in approach for treatment of aortic aneurysms. Initial reporting has shown that EVAS using the Nellix device is safe with similar complication rates to standard endovascular aortic repair (EVAR). What remains unknown is how EVAS technology will behave in the ruptured setting.

A diagnostic evolution: surgical experience with popliteal artery entrapment syndrome at a military tertiary referral center.

Background: Popliteal artery entrapment syndrome (PAES) is an increasingly encountered disorder that typically presents as claudication in young and active individuals. However, despite the increased recognition, accurate preoperative diagnosis can be difficult. The objective of this study was to describe the surgical assessment and outcomes of patients treated for PAES.

A technique for endograft relining of a type IV endoleak using a surgeon-modified internal gate.

Type IV endoleaks represent a rare etiology of late endograft failure; however, depending on the location, they can be extremely challenging to repair with endovascular solutions. We present a method of endograft relining that preserves antegrade limb perfusion, avoids extra-anatomic reconstructions, and ensures complete endograft exclusion.

Mechanism of stent failure in a patient with fibromuscular dysplasia following renal artery stenting.

Endovascular techniques used in the management of renal artery stenosis (RAS) have unique complications, to include stent facture, thrombosis, aneurysm formation, migration, and in-stent restenosis. Described here is an unusual complication of renal artery obstruction and recurrent hypertension without progressive loss of renal function, secondary to intermittent arterial kinking with respiratory and cardiac motion in a patient with fibromuscular dysplasia. This mechanical complication has implication not only in successful endovascular treatment of RAS, but raises questions regarding the alterations in dynamic motion with the cardio-respiratory cycle in stented visceral arteries in other vascular pathologies requiring renal artery stenting (i.

Magnetic resonance imaging: occult popliteal artery entrapment syndrome in a young soldier.

Background: Popliteal artery entrapment syndrome (PAES) is frequently misdiagnosed because of symptom overlap with other conditions and lack of a definitive diagnostic modality. The incidence is widely variable, although it should be considered in all patients under 50 years with symptoms of lower extremity claudication. Long-term sequelae of PAES include critical limb ischemia, arterial occlusion, and aneurysm formation caused by repetitive external compression.

Endovascular aortoiliac reconstruction to allow excision of an infected axillobifemoral bypass.

Axillofemoral graft reconstructions were initially intended to restore lower extremity perfusion in high-risk patients with symptomatic aortoiliac atherosclerotic occlusive disease. However, these reconstructions are now relegated to "bailout" procedures for infected grafts or high-risk critical limb ischemia patients that fail endovascular therapy. Infection of an extra-anatomic bypass graft is a challenging complication as it occurs in poor operative candidates with limited revascularization options and failure has a high rate of amputation and mortality.

Correlation of intravascular ultrasound and computed tomography scan measurements for placement of intravascular ultrasound-guided inferior vena cava filters.

Objective: The single puncture intravascular ultrasound (IVUS)-guided bedside placement of inferior vena cava (IVC) filters has been shown to be an effective technique. The major disadvantage of this procedure is a steep learning curve that can lead to an increased risk of filter malposition. In an effort to increase the safety and efficacy of IVUS-guided bedside IVC filter placement, we proposed that preoperative planning could reduce the incidence of IVUS-guided filter malpositions.

LIHNCS - Lugol's iodine in head and neck cancer surgery: a multicentre, randomised controlled trial assessing the effectiveness of Lugol's iodine to assist excision of moderate dysplasia, severe dysplasia and carcinoma in situ at mucosal resection margins of oral and oropharyngeal squamous cell carcinoma: study protocol for a randomised controlled trial.

Background: Oral cavity and oropharynx cancer are increasing in incidence worldwide but survival outcomes have not significantly improved over the last three decades. The presence of dysplasia or carcinoma in situ at surgical margins following resection of squamous carcinoma of the mucosal surfaces of the head and neck has been shown to be associated with a higher incidence of local recurrence and reduced survival. While invasive carcinoma in mucosal surfaces can usually be distinguished from adjacent normal mucous membrane, pre-malignant disease is much less readily distinguished at operation.

Use of the Internet by patients attending hospital for oral and maxillofacial procedures.

Information obtained on the Internet regarding medical procedures is largely unregulated and can be confusing. The aims of this study were to assess use of the Internet by patients attending hospital for oral and maxillofacial procedures, and to assess the quality of information provided at consultation. Data were collected prospectively using a confidential questionnaire, which was distributed to consecutive patients attending for elective operations at 2 oral and maxillofacial units: Crosshouse Hospital, Kilmarnock, and Queen Alexandra Hospital, Portsmouth (n=100 at each unit).

Use of antibiotic prophylaxis in elective inguinal hernia repair in adults in London and south-east England: a cross-sectional survey.

Purpose: Evidence regarding whether or not antibiotic prophylaxis is beneficial in preventing post-operative surgical site infection in adult inguinal hernia repair is conflicting. A recent Cochrane review based on 17 randomised trials did not reach a conclusion on this subject. This study aimed to describe the current practice and determine whether clinical equipoise is prevalent.

An electrospun polydioxanone patch for the localisation of biological therapies during tendon repair.

Rotator cuff tendon pathology is thought to account for 30-70 % of all shoulder pain. For cases that have failed conservative treatment, surgical re-attachment of the tendon to the bone with a non-absorbable suture is a common option. However, the failure rate of these repairs is high, estimated at up to 75 %.

Kinematic asymmetries of the lower limbs during ergometer rowing.

Purpose: Rowing injuries, particularly of the lumbar spine, are often attributed to poor technique. Rowing technique comprises a series of coordinated movements between the back, upper limbs, and lower limbs, and abnormalities in these may lead to injury. The aim of this study was to test the hypothesis that ergometer rowing is symmetrical with respect to lower limb motion and that deviations from symmetry result from rowing experience, work rate, or stroke position.