Office-Based Steroid Injection for Benign Lesions of the Vocal Folds: Case Series and Review of the Literature.

OBJECTIVES: To present the authors' experience on intralesional steroid injection (ILSI) for benign lesions of the vocal folds and a review of the literature. STUDY DESIGN: Retrospective chart review. METHODS: The medical records of patients with vocal folds nodules, polyps, Reinke's edema, laryngitis/localized edema, and vocal fold granuloma who underwent ILSI were reviewed. Disease regression was assessed by reviewing the video recordings of laryngeal endoscopy before and after surgery. Subjective and objective voice outcome measures were compared before and after office-based ILSI. RESULTS: Forty-seven patients with 81 lesions were included. The most common lesion treated was Reinke's edema followed by vocal fold nodules. All patients who presented for follow-up (n = 37) had partial or complete regression of their disease. When stratified by disease type, vocal fold polyps showed the highest percentage of complete regression (66.7%) followed by vocal fold nodules (65%). The mean voice handicap index-10 (VHI-10) score of the study group dropped from 16.63 ± 6.95 to 6.21 ± 6.09 points (P < 0.001). Patients with vocal fold polyps had the highest drop in the mean VHI-10 score by 16.66 ± 4.73 (P = 0.026). There was no significant difference in the mean acoustic and aerodynamic parameters before and after office-based steroid injection. CONCLUSIONS: ILSI is an effective treatment modality for benign lesions of the vocal folds leading to partial or complete disease regression and self-reported improvement in voice quality.

Treatment Outcomes of Stereotactic Ablative Body Radiotherapy on Extra-cranial Oligometastatic and Oligoprogressive Breast Cancer: Mature Results from a Single Institution Experience.

AIMS: Evidence shows stereotactic ablative body radiotherapy (SABR) is used as a non-invasive ablative therapy in the treatment of multisite oligometastatic (OM) and oligoprogressive (OP) diseases originating from metastatic breast cancer. This study aims to report the treatment outcomes and to investigate what factors that are prognostic in terms of local control, progression-free survival (PFS) and overall survival (OS) in patients receiving SABR for extracranial OM and OP diseases originating from metastatic breast cancer. MATERIALS AND METHODS: A retrospective review on treatment records of patients with OM and OP from metastatic breast cancer who underwent SABR at a single was carried out. SABR was performed with daily image-guided radiotherapy (IGRT) using a dedicated robotic SABR machine. Local control, PFS and OS were calculated using Kaplan-Meier statistics and the post-treatment toxicity data was scored following the CTCAE v4.0 protocol. Univariate and multivariate Cox regression tests were used in the subgroup analysis of prognostic factors on PFS and OS including patients' age, types of follow-up imaging (staging CT only vs whole-body MR/PET), metastases status (OM vs OP), primary breast cancer tumour grade, hormone receptors (ER/PR/HER2) status, change of systemic treatments at SABR, number of metastases, SABR treatment sites and doses. RESULTS: 56 metastatic breast cancer patients (38 patients with OM and 18 patients with OP) were involved in this retrospective review. The median follow-up was 35.6 months (range 4.0-132.9 months). The estimated local control at 1 , 2 and 5 years were 90.9%, 88.7% and 88.7%, respectively. The estimated median PFS was 19.2 months (95%CI 10.3-28.1 months); the PFS at 1, 2 and 5 years were 63.3%, 44.4% and 33.2%. The estimated OS at 1, 2 and 5 years were 98.0%, 91.9% and 74.3%, respectively with the estimated median OS of 105.1 months (95%CI 51.5-158.7 months). The vast majority of patients tolerated the treatment well with the commonest acute side effects as grade 1 fatigue. There were no statistically significant factors found in OS regression analysis. The types of follow-up imaging, metastases status, oestrogen receptor status, and number of metastases for SABR were statistically significant factors (p < 0.05) in the multivariate Cox regression analysis on PFS. CONCLUSION: There are limited studies published on the efficacy and post-treatment toxicities of metastatic breast cancer OM and OP SABR with adequate length of follow-up. This study confirmed that SABR was a safe, non-invasive treatment option for patients with extracranial OM and OP diseases originated from primary breast cancer in terms of the acceptable post-treatment toxicities.

Design of Modified Polymer Membranes Using Machine Learning.

Surface modification is an attractive strategy to adjust the properties of polymer membranes. Unfortunately, predictive structure-processing-property relationships between the modification strategies and membrane performance are often unknown. One possibility to tackle this challenge is the application of data-driven methods such as machine learning. In this study, we applied machine learning methods to data sets containing the performance parameters of modified membranes. The resulting machine learning models were used to predict performance parameters, such as the pure water permeability and the zeta potential of membranes modified with new substances. The predictions had low prediction errors, which allowed us to generalize them to similar membrane modifications and processing conditions. Additionally, machine learning methods were able to identify the impact of substance properties and process parameters on the resulting membrane properties. Our results demonstrate that small data sets, as they are common in materials science, can be used as training data for predictive machine learning models. Therefore, machine learning shows great potential as a tool to expedite the development of high-performance membranes while reducing the time and costs associated with the development process at the same time.

Nutrition education and its relationship to body image and food intake in Asian young and adolescents: a systematic review.

Background: The literature brings to light the unhealthy nutritional habits prevalent among Asian adolescents and their high level of body image dissatisfaction. This study aims to conduct a systematic review of the literature on the effect of nutritional education interventions on their nutritional knowledge and food intake behavior, attitude, practice, and body image. Methods: We searched relevant published studies in PubMed, Web of Science, Scopus, Science Direct, and Springer using the PICO framework and performed a quality assessment using the 10-point checklist adapted from the National Institutes for Health tool. Results: The majority of the nutritional education interventions improve unhealthy food intake and body image misperception, particularly on nutritional knowledge/self-efficacy, healthy dietary habits, physical activities, and fruit and vegetable intake. We also found a negative association with excess weight gain, obesity, and unethical weight reduction practices, leading to dissatisfaction with body image. Conclusion: These interventions can help address dietary problems and body image perception and support the development of future interventions.

Public Awareness of Common Age-Related Eye Diseases in Northern Saudi Arabia.

Background: Visual impairment and blindness pose substantial public health challenges in Saudi Arabia, especially among the elderly susceptible to blinding eye diseases. Assessing awareness of age-related eye diseases (AREDs) is vital for addressing vision loss in this demographic. However, there is a lack of research on ARED awareness in Northern Saudi Arabia, underscoring the need for evidence-based data from adult populations to craft effective health promotion strategies. METHODS: This population-based descriptive survey was conducted on 411 Saudi adults aged 18-70 residing in Arar City, Saudi Arabia, over six months from September 2023. Random sampling was employed, and awareness levels were assessed using a pre-designed questionnaire. Data analysis was performed using Statistical Product and Service Solutions (SPSS, version 20.0; IBM SPSS Statistics for Windows, Armonk, NY). RESULTS:  Among the 411 participants, 225 (54.7%) were aged 18-29 years, 312 (76%) were females, and 299 (72.6%) held a bachelor's degree or diploma. Regarding awareness, 71.3% knew about cataracts, but nearly half erroneously believed it could be treated solely medically. For diabetic retinopathy (DR), 366 (89%) recognized lifestyle modifications, and 378 (92%) understood screening as preventive measures. Most participants understood prevention methods for all four diseases, but misconceptions about treatment options were observed. Awareness of glaucoma and age-related macular degeneration (ARMD) was lower. No significant age-related differences were found in awareness, except for cataracts (P = 0.001). Education significantly influenced awareness of cataracts, DR, and glaucoma (P = 0.001, 0.013, and 0.008, respectively), but not ARMD (P = 0.606). The study found that the internet is the primary source of information on AREDs for most participants, except for cataracts, where friends and relatives are prominent. CONCLUSION: The study reveals varying awareness levels of AREDs among Saudi adults. Although most participants understood preventive measures, misconceptions about treatment underscore the need for accurate education channels. Healthcare professionals must ensure information reliability to effectively combat misinformation and enhance awareness of AREDs.

Exploratory study of using Magnetic resonance Prognostic Imaging markers for Radiotherapy In Cervix cancer (EMPIRIC): a prospective cohort study protocol.

INTRODUCTION: Radical chemoradiotherapy represents the gold standard for locally advanced cervical cancer. However, despite significant progress in improving local tumour control, distant relapse continues to impact overall survival. The development of predictive and prognostic biomarkers is consequently important to risk-stratify patients and identify populations at higher risk of poorer treatment response and survival outcomes. Exploratory study of using Magnetic resonance Prognostic Imaging markers for Radiotherapy In Cervix cancer (EMPIRIC) is a prospective exploratory cohort study, which aims to investigate the role of multiparametric functional MRI (fMRI) using diffusion-weighed imaging (DWI), dynamic contrast-enhanced (DCE) and blood oxygen level-dependent imaging (BOLD) MRI to assess treatment response and predict outcomes in patients undergoing radical chemoradiotherapy for cervical cancer. METHODS AND ANALYSIS: The study aims to recruit 40 patients across a single-centre over 2 years. Patients undergo multiparametric fMRI (DWI, DCE and BOLD-MRI) at three time points: before, during and at the completion of external beam radiotherapy. Tissue and liquid biopsies are collected at diagnosis and post-treatment to identify potential biomarker correlates against fMRI. The primary outcome is to evaluate sensitivity and specificity of quantitative parameters derived from fMRI as predictors of progression-free survival at 2 years following radical chemoradiotherapy for cervical cancer. The secondary outcome is to investigate the roles of fMRI as predictors of overall survival at 2 years and tumour volume reduction across treatment. Statistical analyses using regression models and survival analyses are employed to evaluate the relationships between the derived parameters, treatment response and clinical outcomes. ETHICS AND DISSEMINATION: The EMPIRIC study received ethical approval from the NHS Health Research Authority (HRA) on 14 February 2022 (protocol number RD2021-29). Confidentiality and data protection measures are strictly adhered to throughout the study. The findings of this study will be disseminated through peer-reviewed publications and scientific conferences, aiming to contribute to the growing body of evidence on the use of multiparametric MRI in cervical cancer management. TRIAL REGISTRATION NUMBER: NCT05532930.

A qualitative examination of factors influencing pregnancy-related anxiety in Northern Ghana.

INTRODUCTION: Despite high prevalence of anxiety among pregnant women in low- and -middle-income countries, research on context-specific conceptualisation, measurement, and predictors of pregnancy-related anxiety (PrA) is limited in these contexts. We explored local conceptualisations of factors influencing PrA in the Northern Region of Ghana. METHODS: We conducted 15 focus group discussions with antenatal care seekers in the Mion District, Savelugu Municipality, and Tamale Metropolis of the Northern Region, in July and August 2021. Multistage stratified purposive sampling was used to select respondents (n = 108). The data were audio-recorded and transcribed, and then we conducted a thematic analysis of the data. RESULTS: At the individual level, fear of anaemia; pre-existing health conditions; challenges with daily activities; and physical, emotional, and sexual abuses from spouses contributed to PrA. Health system failures resulting in unexpected out-of-pocket payments, negative health worker attitudes, diagnostic errors, constraints on birth preparation and birth process, and potential adverse birth outcomes were understood as driving PrA. Socio-cultural factors influencing PrA comprised beliefs and practices around baby naming/outdooring ceremonies, fear of spiritual attacks, social construction of gender roles, and contextual factors such as transportation challenges. CONCLUSION: Pregnant women in the region understood, experienced, and could identify perceived predictors of PrA. To address PrA, we recommend that mental health services should be integrated into the basic package of antenatal care and rural health services should be improved. Perceived predictors of PrA identified here could be included in the design of a context-specific PrA measure for use in the region.

Remediation of oily-produced water from high-salinity oilfield using a low-cost, high-alumina calcium bentonite hollow fiber membrane.

Discharging improperly treated oily-produced water (OPW) into the environment can have significant negative impacts on environmental sustainability. It can lead to pollution of water sources, damage to aquatic ecosystems and potential health hazards for individuals living in the affected areas. Ceramic hollow fiber membrane (CHFM) technology is one of the most effective OPW treatment methods for achieving high oil removal efficiency while maintaining membrane water permeability. In this study, low-cost calcium bentonite hollow fiber membranes (CaB-HFMs) were prepared from high-alumina calcium bentonite clay with various preparation parameters, including calcium bentonite content, sintering temperature, air gap distance and bore fluid rate. The prepared CaB-HFMs were then subjected to characterization using scanning electron microscopy (SEM), a three-point bending test, porosity, average pore size, hydraulic resistance and flux recovery ratio (FRR) analysis. Statistical analysis employing central composite design (CCD) assessed the interaction between the parameters and their effect on CaB-HFM water permeability and oil removal efficiency. Higher ceramic content and sintering temperature led to reduced porosity, smaller pore size and higher mechanical strength. In contrast, increasing the air gap distance and bore fluid rate exhibit different trends, resulting in higher porosity and pore size, along with weaker mechanical strength. Other than that, all of the CaB-HFMs displayed low hydraulic resistance (<0.01 m2 h.bar/L) and high FRR value (up to 95.2%). Based on CCD, optimal conditions for CaB-HFM were determined as follows: a calcium bentonite content of 50 wt.%, a sintering temperature of 1096 °C, an air gap distance of 5 cm and a bore fluid rate of 10 mL/min, with the desirability value of 0.937. Notably, the optimized CaB-HFMs demonstrated high oil removal efficiency of up to 99.7% with exceptional water permeability up to 535.2 L/m2.h.bar. The long-term permeation study also revealed it was capable of achieving a high average water permeation and a stable oil rejection performance of 522.15 L/m2.h.bar and 99.8%, respectively, due to their inherent hydrophilic and antifouling characteristics, making it practical for OPW treatment application.

Chromolaena odorata layered-nitrile rubber polymer transdermal patch enhanced wound healing in vivo.

The objective is to investigate the healing efficacy of a Chromolaena odorata layered-nitrile rubber transdermal patch on excision wound healing in rats. Wounds were induced in Sprague-Dawley rats and were later treated as follows: wound A, the negative control, received no treatment (NC); wound B, the negative control with an empty nitrile rubber patch (NC-ERP); wound C, treated with a C. odorata layered-nitrile rubber patch (CO-NRP); and wound D, the positive control with Solcoseryl gel with a nitrile rubber patch (PC-SG-NRP). After 1, 3, 6, 10, and 14 days, the rats were sacrificed and analyzed for wound contraction, protein content, hexosamine, and uronic acid levels. Macroscopic observation showed enhanced wound healing in wounds treated with CO-NRP with a wound contraction percentage significantly higher (p<0.05) on days 6 and 10 compared to those treated with NC-ERP. Similarly, protein, hexosamine, and uronic acid contents were also significantly higher (p<0.05) in CO-NRP-treated wounds when compared with wounds treated with NC-ERP. Histological findings showed denser collagen deposition and faster granulation tissue formation in wounds treated with CO-NRP. From the results obtained, it is concluded that the C. odorata layered-nitrile rubber transdermal patch was effective in healing skin wounds.

Immobilization of Bi2WO6 on Polymer Membranes for Photocatalytic Removal of Micropollutants from Water - A Stable and Visible Light Active Alternative.

In this work, bismuth tungstate Bi2WO6 is immobilized on polymer membranes to photocatalytically remove micropollutants from water as an alternative to titanium dioxide TiO2. A synthesis method for Bi2WO6 preparation and its immobilization on a polymer membrane is developed. Bi2WO6 is characterized using X-ray diffraction and UV-vis reflectance spectroscopy, while the membrane undergoes analysis through scanning electron microscopy, X-ray photoelectron spectroscopy, and degradation experiments. The density of states calculations for TiO2 and Bi2WO6, along with PVDF reactions with potential reactive species, are investigated by density functional theory. The generation of hydroxyl radicals OH• is investigated via the reaction of coumarin to umbelliferone via fluorescence probe detection and electron paramagnetic resonance. Increasing reactant concentration enhances Bi2WO6 crystallinity. Under UV light at pH 7 and 11, the Bi2WO6 membrane completely degrades propranolol in 3 and 1 h, respectively, remaining stable and reusable for over 10 cycles (30 h). Active under visible light with a bandgap of 2.91 eV, the Bi2WO6 membrane demonstrates superior stability compared to a TiO2 membrane during a 7-day exposure to UV light as Bi2WO6 does not generate OH• radicals. The Bi2WO6 membrane is an alternative for water pollutant degradation due to its visible light activity and long-term stability.

Elucidating the daily foraging activity pattern of Oecophylla smaragdina to minimize bite nuisances in Asia large agro-system plantations.

Oecophylla smaragdina F., the Asian weaver ant, is one of the oil palm plantation's (Elaeis guineensis) potential predators, for the invasive bagworm species Metisa plana Walker, but this ant is a nuisance species that irritates plantation workers with their sharp bites. Here we assess the foraging activities (FA) of O. smaragdina's major workers, identify its inactive times and the existence of supervision, a novelty for social insects. Between 2018 and 2022, the pattern of trunk foraging activity was used as a mitigation measure. The relationship between trunk FA and air temperature (AT), relative humidity (RH), air pressure (AP), and rainfall interception (RI) was also investigated. Our results showed that, O. smaragdina is a strictly diurnal ant species, has little to no crepuscular activity, and stopped foraging during darkness. Moreover, veteran bigger workers systematically acted as supervisors by monitoring trails, intercepting, and bringing back to nests smaller individuals during heat peaks. In relation to population size relative abundance, all colonies displayed greater intensity during the warmest daily periods with higher mean forager density among the bigger colony, regardless of the dry-rainy intervals corresponded to minimal activity from late scotophase to early photophase and showed a bimodal pattern. Thus, forager activity peaked between 1100-1530 h and 1745-1845 h, and an average two-fold daily sudden decrease in intensity between 1620 and 1650 h as a partial cut-off period (first report). Furthermore, foraging activity, AT, AP showed a significant positive correlation while RH was negative. Finally, we found that from the base palm trunks, defensive territorial layers extended to 5 m on average with different spatial configurations indicating greater foraging density within the first 2 m. Our study shows O. smaragdina daily low activity periods, before 1000 h, being the most suitable to avoid forager attacks to facilitate pruning and harvesting tasks.

Evaluation of HACOR scale as a predictor of non-invasive ventilation failure in acute cardiogenic pulmonary oedema patients: A prospective observational study.

BACKGROUND AND IMPORTANCE: Acute cardiogenic pulmonary oedema (ACPO) is a common indication for non-invasive ventilation (NIV) in the emergency department (ED). HACOR score of >5 is used to predict NIV failure. The predictive ability of HACOR may be affected by altered physiological parameters in ACPO patients due to medications or comorbidities. OBJECTIVES: To validate the HACOR scale in predicting NIV failure among acute cardiogenic pulmonary oedema (ACPO) patients. DESIGN, SETTINGS AND PARTICIPANTS: This is a prospective, observational study of consecutive ACPO patients requiring NIV admitted to the ED. OUTCOME MEASURE AND ANALYSIS: Primary outcome was the ability of the HACOR score to predict NIV failure. Clinical, physiological, and HACOR score at baseline and at 1 h, 12 h and 24 h were analysed. Other potential predictors were assessed as secondary outcomes. MAIN RESULTS: A total of 221 patients were included in the analysis. Fifty-four (24.4%) had NIV failure. Optimal HACOR score was >5 at 1 h after NIV initiation in predicting NIV failure (AUC 0.73, sensitivity 53.7%, specificity 83.2%). As part of the HACOR score, respiratory rate and heart rate were not found to be significant predictors. Other significant predictors of NIV failure in ACPO patients were acute coronary syndrome, acute kidney injury, presence of congestive heart failure as a comorbid, and the ROX index. CONCLUSIONS: The HACOR scale measured at 1 h after NIV initiation predicts NIV failure among ACPO patients with acceptable accuracy. The cut-off level > 5 could be a useful clinical decision support tool in ACPO patient. However, clinicians should consider other factors such as the acute coronary and acute kidney diagnosis at presentation, presence of underlying congestive heart failure and the ROX index when clinically deciding on timely invasive mechanical ventilation.

Salvage brachytherapy for second ipsilateral breast tumor event: Relating dosimetric analysis to late side effects.

PURPOSE: For second ipsilateral breast tumor event (2ndIBTE), conservative treatment (CT) involving wide local excision plus accelerated partial breast reirradiation (APBrI) is increasingly used as an alternative to mastectomy. This study investigates the impact of APBrI technique and multicatheter interstitial high dose-rate brachytherapy (MIB) dosimetry parameters on toxicity and survival in patients with 2ndIBTE. MATERIALS-METHODS: Data from patients with 2ndIBTE treated with CT, were analyzed. Inclusion criteria specified 2ndIBTE occurring at least one year after 1st CT for primary breast cancer. Treatment details and dosimetry parameters were recorded. Primary endpoint was late toxicity. Secondary endpoints were late toxicity prognostic factors analysis and oncological outcome. RESULTS: From 07/2005 and 07/2023, 201 patients (pts) received 2nd CT. With a median follow-up of 49.6 months (44.9-59.5), tumor size was less than 2 cm (88.1%), with estrogen receptor positive (92.7%). Patients were low (63.7%) or intermediate (29.8%) GEC-ESTRO APBI risk classification. Late toxicities were observed in 34.8% (G1 52.3%, G2 40.7%). Cutaneous fibrosis was the most common toxicity. Cosmetic outcomes were excellent in 64.1%. Dosimetry analysis revealed positive correlations between complications and absolute volumes of CTV, V100, V150, and V200. Volumes requiring higher needle number and lower DNR resulted in fewer complications. 5-year disease-free and overall survival were 88% and 95% respectively. CONCLUSION: Second CT for 2ndIBTE showed favorable oncological outcomes and survival rates. Complications were correlated with specific dosimetric parameters, emphasizing the importance of tailored treatment planning. This study provides valuable insights in risk stratification and MIB optimization for APBrI.

The complete plastome sequences of invasive weed Parthenium hysterophorus: genome organization, evolutionary significance, structural features, and comparative analysis.

Parthenium hysterophorus, a globally widespread weed, poses a significant threat to agricultural ecosystems due to its invasive nature. We investigated the chloroplast genome of P. hysterophorus in this study. Our analysis revealed that the chloroplast genome of P. hysterophorus spans a length of 151,881 base pairs (bp). It exhibits typical quadripartite structure commonly found in chloroplast genomes, including inverted repeat regions (IR) of 25,085 bp, a small single copy (SSC) region of 18,052 bp, and a large single copy (LSC) region of 83,588 bp. A total of 129 unique genes were identified in P. hysterophorus chloroplast genomes, including 85 protein-coding genes, 36 tRNAs, and eight rRNAs genes. Comparative analysis of the P. hysterophorus plastome with those of related species from the tribe Heliantheae revealed both conserved structures and intriguing variations. While many structural elements were shared among the species, we identified a rearrangement in the large single-copy region of P. hysterophorus. Moreover, our study highlighted notable gene divergence in several specific genes, namely matK, ndhF, clpP, rps16, ndhA, rps3, and ndhD. Phylogenetic analysis based on the 72 shared genes placed P. hysterophorus in a distinct clade alongside another species, P. argentatum. Additionally, the estimated divergence time between the Parthenium genus and Helianthus (sunflowers) was approximately 15.1 million years ago (Mya). These findings provide valuable insights into the evolutionary history and genetic relationships of P. hysterophorus, shedding light on its divergence and adaptation over time.

Risk of Fibromyalgia in Patients with Primary Muscle Tension Dysphonia: A Prospective Pilot Study.

OBJECTIVE: To investigate the risk of fibromyalgia in patients with primary muscle tension dysphonia (MTD) in comparison to subjects with no dysphonia. STUDY DESIGN: Prospective cohort study. METHODS: The medical records and video recordings of all patients presenting to the Voice and Swallowing unit at a tertiary referral center between October 2022 and October 2023 and who were diagnosed with primary MTD were prospectively reviewed. The risk of fibromyalgia was assessed using the "Fibromyalgia Rapid Screening Tool" (FiRST). Demographic data included age, gender, history of smoking, and history of high vocal load. The impact of dysphonia on quality of life was also analyzed using the Voice Handicap Index-10 (VHI-10). RESULTS: A total of 42 patients who had filled the FiRST questionnaire were enrolled in this study. These included 20 patients diagnosed with primary MTD and 22 healthy subjects with no history of dysphonia and normal laryngeal examination. Forty percent of the study group tested positive using the FiRST questionnaire as compared to only 9.1% in the control group. The difference between the two groups was statistically significant (P = 0.03). The risk of having fibromyalgia was 6.67 times among patients with primary MTD in comparison to controls (RR=6.67; 95% CI [1.21-36.74]). CONCLUSION: The results of this investigation indicate that the risk of fibromyalgia is significantly higher in patients with primary MTD vs controls. A holistic approach in the diagnosis and treatment of MTD is advocated.

Arytenoid Cartilage Collapse During Inhalation in Awake Patients with Intermediate/High Risk of Obstructive Sleep Apnea: A Retrospective Analysis of Sixty-Four Patients.

OBJECTIVE: To assess the prevalence of arytenoid cartilage collapse (ACC) during deep inhalation in awake patients with intermediate/high risk of obstructive sleep apnea (OSA). STUDY DESIGN: Retrospective case-control study. METHODS: The medical records and video recordings of awake flexible endoscopic examination of patients with history of OSA who presented to the sleep apnea clinic in a tertiary referral medical center between June 2022 and December 2022, were reviewed. All patients had filled the STOP-BANG questionnaire and had intermediate/high risk of having OSA. A group of patients matched by age and gender and with no history of OSA were used as controls. RESULTS: A total of 95 patients, 64 with a history of OSA and 31 with no history of OSA, were included. Among the study group, 37.5% (n = 24) had a STOP-BANG score between 3 and 4 and were considered to be at an intermediate risk of OSA while the remaining had a score more than 5 and were considered to be at high risk of OSA. There was a significant difference in the prevalence of ACC between the study group and controls (32.8% vs 12.9%, respectively, P < 0.001). CONCLUSION: The prevalence of ACC was significantly higher in patients with intermediate/high risk of OSA in comparison to healthy controls with no history of OSA. When present, ACC should raise the physician's suspicion for OSA and probably prompt further investigation such as a sleep study.

Plant-based calcium silicate from rice husk ash: A green adsorbent for free fatty acid recovery from waste frying oil.

Driven by the urgent need for a solution to tackle the surge of rice husk (RH) and waste frying oil (WFO) waste accumulation at a global scale, this report highlights the use of calcium silicates (CS) extracted from acid-pre-treated rice husk ash (RHA) for free fatty acid (FFA) removal from WFO as conventional RHA shows limited FFA adsorption performance. A novel alkaline earth silicate extraction method from acid-pre-treated RHA was outlined. The structural and behavioural attributes of the synthesised CS were identified through BET, SEM-EDS, and XRD analyses and compared to those of RHA. Notable morphology and structural modification were determined, including reducing specific surface areas, mitigating from amorphous to crystalline structure with regular geometric forms, and detecting Si-O-Ca functional groups exclusive to CS adsorbents. A comparison study showed superior lauric acid (LA) adsorption performance by CS absorbents over acid-pre-treated RHA, with a significant increase from 0.0831 ± 0.0004 mmol LA/g to 2.5808 ± 0.0011 mmol LA/g after 60 min. Recognised as the best-performing CS adsorbent, CS-1.0 was used for further investigations on the effect of dosage, LA concentration, and temperature for efficient LA adsorption, with up to 100% LA removal and 5.6712 ± 0.0016 mmol LA/g adsorption capacity. The adsorption isotherm and kinetic studies showed LA adsorption onto CS-1.0 followed Freundlich isotherm with KF = 0.0598 mmol(1-1/n) L(1/n) g-1 & Qe,cal = 3.1696 mmol g-1 and intraparticle diffusion model with kid = 0.1250 mmol g-1 min0.5 & Ci = 0.9625 mmol g-1, indicating rapid initial adsorption and involvement of carboxylate end of LA and the calcium ions on the CS-1.0 in the rate-limiting step. The high equilibrium adsorption capacity and LA adsorption rate indicated that the proposed CS-1.0 adsorbent has excellent potential to recover FFA from WFO effectively.

The sensitivity of laryngeal findings in predicting high-grade dysplasia in patients with vocal fold leukoplakia undergoing office-based biopsies: A retrospective analysis of 100 cases.

Objective: To investigate the sensitivity of laryngeal findings in predicting high-grade dysplasia/carcinoma in situ (CIS) and squamous cell carcinoma (SCC) in patients with vocal fold leukoplakia. Methods: A retrospective review of the medical records and video recordings of the laryngeal examination of patients with vocal fold leukoplakia who underwent un-sedated office-based laryngeal biopsy in a tertiary referral center between January 2022 and August 2023 was conducted. Laryngeal findings included the size, surface, projection, and edges of the lesion. Vocal fold leukoplakia was classified according to the WHO as benign, low-grade dysplasia, high-grade dysplasia/CIS, and squamous cell carcinoma. Results: Seventy patients with 100 vocal fold leukoplakia were included. Size was found to have the highest sensitivity with an AUC of 0.730 (95% CI [0.618-0.842], p = 0.002) followed by surface and projection with AUCs of 0.672 (95% CI [0.548-0.795], p = 0.019) and 0.675 (95% CI [0.546-0.804], p = 0.017), respectively. Furthermore, the odds of diagnosing high-risk lesions (high-grade dysplasia/CIS and SCC) were the greatest when the lesion was large and rough (OR = 10.28; 95% CI [3.08-34.36]). Conclusion: The morphological features of vocal fold leukoplakia may assist the physician in predicting the risk of malignancy. Large and rough lesions were more likely to harbor high-grade dysplasia/CIS and SCC compared to small and smooth lesions.