Concerns regarding health-related social media usage amongst otolaryngology patients.

PURPOSE: The objective of this study was to determine concerns of otolaryngology patients regarding health-related social media usage. METHODS: A total of 372 otolaryngology patients were asked to report their level of concern (on a scale of "not at all", "a little", "somewhat", or "highly" concerned) regarding health-related social media usage as it pertained to risk of "loss of privacy or anonymity related to your health condition", "reliability of disease/treatment information", and "reliability of physician reviews/recommendations". Demographics and social media usage patterns (on Facebook, Instagram, Twitter, TikTok or other platforms) were compared to concerns about health-related social media usage. RESULTS: The level of concern was highest for reliability of disease/treatment information and least for loss of privacy/anonymity (p < 0.001). Concern about loss of privacy/anonymity was associated with age over 25 years (OR = 3.12, 95%CI 1.66-5.86, p < 0.001) and negatively with daily use of Twitter (OR = 0.54, 95%CI 0.30-0.96, p = 0.035). Concern about reliability of disease/treatment information was negatively associated with Medicare insurance (OR = 0.57, 95%CI 0.35-0.93, p = 0.024), which is available to adults aged ≥65 years, and concern over reliability of physician reviews/recommendations was associated with patients identifying their race as Asian, American Indian and other (OR = 3.16, 95%CI 1.22-8.19, p = 0.018). CONCLUSIONS: The greatest concern about health-related social media usage is related to reliability of disease/treatment information, though notably less among patients with Medicare who represent adults of age 65 years or older. Concerns over loss of privacy/anonymity and reliability of physician reviews/recommendations are also prevalent and associated with patient demographics. These concerns may constrain utilization of social media for healthcare purposes, which highlights the importance of reliable sources of information.

Patient perspectives on recall period and response options in patient-reported outcome measures for chronic rhinosinusitis symptomatology: An international multi-centered study.

BACKGROUND: Existing patient-reported outcome measures (PROMs) for chronic rhinosinusitis (CRS) use a variety of recall periods and response scales to assess CRS symptom burden. Global perspectives of CRS patients regarding optimal recall periods and response scales for CRS PROMs are unknown. METHODS: This was a multi-center, cross-sectional study recruiting 461 CRS patients from sites across the United States, Saudi Arabia, New Zealand, and Austria. Participants chose which CRS symptom recall period (1 day, 2 weeks, 1 month, >1 month) was most reflective of their current disease state and upon which to best base treatment recommendations (including surgery). Participants also chose which of six response scales (one visual analogue scale and five Likert scales ranging from four to eight items) was easiest to use, understand, and preferred. RESULTS: A plurality of participants (40.0%) felt their CRS symptoms' current state was best reflected by a 1-month recall period. However, most patients (56.9%) preferred treatment recommendations to be determined by symptoms experienced over a >1 month period. The four- and five-item Likert scales were the easiest to understand (26.0% and 25.4%, respectively) and use (23.4% and 26.7%, respectively). The five-item (26.4% rating it most preferred and 70.9% rating it preferred) and four-item Likert (22.3% rating it most preferred and 56.4% rating it preferred) response scales were most preferred. CONCLUSION: Future PROMs for CRS should consider assessment of symptoms over a 1-month period and use a four- or five-item Likert response scale to reflect global patient preferences. These findings also inform interpretation of current CRS PROMs.

Impact of medical treatment for chronic rhinosinusitis on eustachian tube dysfunction.

KEY POINTS: CRS patients treated with medical management have improvement in ETD symptoms as reflected by lower ETDQ-7 scores However, appropriate CRS medical management may be limited in ability to significantly improve, or resolve, ETD.

A Novel Instrument Holder to Improve Operative Efficiency in Endoscopic Laryngeal and Airway Surgery.

OBJECTIVE: Receiving instruments from surgical technicians during endoscopic laryngeal and airway microsurgery (ELAM) has challenges including repeated, expeditious handling of delicate instruments and passing them to the surgeon's hand opposite of where the surgical assistant is standing. Optimizing this interaction may reduce surgical errors and improve operative efficiency. METHODS: A proprietary ELAM instrument holder was attached to both sides of the operating room bed. The device consisted of an articulating arm with custom silicone inserts mounted on a tray (storing up to three endoscopic instruments). ELAM cases were randomized to be performed either with (device) or without the holder (control). Using custom software, instrument pass time (IPT), instrument drop rate (IDR), and communication errors (eg handing incorrect instruments) were manually recorded. Qualitative use metrics relating to overall device satisfaction were also obtained. RESULTS: Data were collected from 25 device and 23 control cases among three different laryngologists. Average IPT was nearly three times quicker for the device (0.80 s, n = 1175 passes) compared with controls (2.09 s, n = 1208 passes) [p < 0.001]. IPT interquartile range was five times higher for control (1.65 s) versus device cases (0.42 s). IDR was not significantly different [p = 0.48]; however, device cases had significantly lower communication errors compared to control cases [p = 0.01]. Surgeons and surgical assistants were similarly satisfied with the device on a 5-point Likert scale (mean: 4.2/5, standard deviation: 0.92). CONCLUSION: The proposed endoscopic instrument holder can improve ELAM operative workflow by reducing instrument passing time and variability without increasing IDR. LEVEL OF EVIDENCE: 2 Laryngoscope, 133:3492-3498, 2023.

The Burden of Migraine on Quality of Life in Chronic Rhinosinusitis.

OBJECTIVE: To determine the impact of comorbid migraine on quality of life (QOL) in chronic rhinosinusitis (CRS). METHODS: A total of 213 adult patients with CRS were recruited. All participants completed the 22-item Sinonasal Outcome Test (SNOT-22), from which total and validated nasal, ear/facial pain, sleep, and emotional subdomain scores were calculated, and the 5-dimension EuroQol general health questionnaire (EQ-5D), from which the visual analogue scale (VAS) and health utility value (HUV) were calculated. The presence of comorbid migraine was determined by a score of ≥4 on the 5-item Migraine Screen Questionnaire (MS-Q). RESULTS: Of the participants, 36.2% were screened positive for having comorbid migraine. The mean SNOT-22 score was 64.9 (SD: 18.7) in participants with migraine and 41.5 (SD: 21.1) in participants without migraine (p < 0.001). The mean EQ-5D VAS and HUV were 60.2 (SD: 21.9) and 0.69 (SD: 0.18), respectively, in participants with migraine and 71.4 (SD: 19.4) and 0.84 (SD: 0.13), respectively, in participants without migraine (p < 0.001 for both). Higher ear/facial pain (OR = 1.22, 95% CI: 1.10-1.36, p < 0.001) and sleep (OR = 1.11, 95% CI: 1.04-1.18, p = 0.002) SNOT-22 subdomain scores were positively associated with migraine. The SNOT-22 item scores related to dizziness, reduced concentration, and facial pain, in descending order, were most associated with migraine. The presence of nasal polyps (OR = 0.24, 95% CI: 0.07 - 0.80, p = 0.020) was negatively associated with migraine. CONCLUSION: Comorbid migraine may be relatively common amongst CRS patients, and its presence is associated with significantly worse QOL. Dizziness as a symptom in CRS patients may be particularly indicative of migraine. LEVEL OF EVIDENCE: 3 Laryngoscope, 133:3279-3284, 2023.

Surveying the Landscape of Social Media Usage for Health Care by Otolaryngology Patients.

OBJECTIVE: To determine factors associated with social media usage for finding a doctor or seeking medical advice among otolaryngology patients. METHODS: Cross-sectional study of 361 patients visiting our clinics. All participants were asked if they were aware social media may be used to find doctors and if they had ever done so, and also if they were aware social media could be used to get advice about a medical condition or its treatment and if they had ever done so. Demographic characteristics were examined for association with affirmative answers to these questions. RESULTS: Facebook was the most used social media platform with 50.7% using Facebook daily. Over 50% of participants were aware social media could be used to find a doctor or seek medical advice. Daily use of Facebook was associated with using social media for finding a doctor (OR = 2.57, 95%CI: 1.41-4.67, p = 0.002) and seeking medical advice (OR = 1.72, 95%CI: 1.09-2.71, p = 0.020). Having Medicare was associated with using social media to find a doctor (OR = 2.20, 95%CI: 1.15-4.21, p = 0.017), whereas Medicaid was associated with using social media for medical advice (OR = 1.99, 95%CI: 1.08-3.67, p = 0.027). CONCLUSION: A majority of otolaryngology patients may be aware of health care applications of social media, with Facebook being the dominant platform, and Medicare insurance identifying patients who may most use social media in this manner. There is also an indication that social determinants of health, as reflected by Medicaid insurance, may be associated with using social media to seek medical advice. LEVEL OF EVIDENCE: NA Laryngoscope, 133:2116-2121, 2023.

Describing the relationships among meat quality traits in domestic turkey (Meleagris gallopavo) populations.

The presence of meat quality defects is increasing in the turkey industry. While the main strategy for mitigating these issues is through improved housing, management, and slaughter conditions, it may be possible to incorporate meat quality into a turkey breeding strategy with the intent to improve meat quality. Before this can occur, it is important to describe the current state of turkey meat quality as well as the correlations among the different meat quality traits and important production traits. The main objective of the present study was to provide a descriptive analysis of 8 different meat quality traits for turkey breast meat from 3 different purebred lines (A, B, and C), and their correlation with a selection of production traits. Using a total of 7,781 images, the breast meat (N = 590-3,892 birds depending on trait) was evaluated at 24 h postmortem for color (L*, a*, b*), pH, and physiochemical characteristics (drip loss, cooking loss, shear force). Descriptive statistics (mean and standard deviation) and Pearson correlations were computed to describe the relationships among traits within each genetic line. A one-factor ANOVA and post hoc t-test were conducted for each trait and between each of the genetic lines. We found significant differences between genetic lines for some color traits (L* and a*), pHinitial, drip loss, and cooking loss. The lightest line in weight (line B) had meat that was the lightest (L*) in color. The heaviest line (line C) had meat that was less red (a*) with a higher pHinitial and greater cooking loss. Unfavorable correlations between production traits and meat quality were also found for each of the genetic lines where increases in production (e.g., body weight, growth rate) resulted in meat that was lighter and redder in color and in some cases (line B and C), with an increased moisture loss. The results of this study provide an important benchmark for turkey meat quality in purebred lines and provide an updated account of the relationships between key production traits and meat quality. Although the magnitude of these correlations is low, their cumulative effect on meat quality can be more significant especially with continued selection pressure on growth and yield.

Investigating inbreeding in the turkey (Meleagris gallopavo) genome.

The detrimental effects of increased homozygosity due to inbreeding have prompted the development of methods to reduce inbreeding. The detection of runs of homozygosity (ROH), or contiguous stretches of homozygous marker genotypes, can be used to describe and quantify the level of inbreeding in an individual. The estimation of inbreeding coefficients can be calculated based on pedigree information, ROH, or the genomic relationship matrix. The aim of this study was to detect and describe ROH in the turkey genome and compare estimates of pedigree-based inbreeding coefficients (FPED) with genomic-based inbreeding coefficients estimated from ROH (FROH) and the genomic relationship matrix (FGRM). A total of 2,616,890 pedigree records were available. Of these records, 6,371 genotyped animals from three purebred turkey (Meleagris gallopavo) lines between 2013 and 2019 were available, and these were obtained using a dense single nucleotide polymorphism array (56,452 SNPs). The overall mean length of detected ROH was 2.87 ± 0.29 Mb with a mean number of 84.87 ± 8.79 ROH per animal. Short ROH with lengths of 1 to 2 Mb long were the most abundant throughout the genome. Mean ROH coverage differed greatly between chromosomes and lines. Considering inbreeding coefficient means across all lines, genomic derived inbreeding coefficients (FROH = 0.27; FGRM = 0.32) were higher than coefficients estimated from pedigree records (FPED = 0.14). Correlations between FROH and FPED, FROH and FGRM, and FPED and FGRM ranged between 0.19 to 0.31, 0.68 to 0.73, and 0.17 to 0.30, respectively. Additionally, correlations between FROH from different lengths and FPED substantially increased with ROH length from -0.06 to 0.33. Results of the current research, including the distribution of ROH throughout the genome and ROH-derived inbreeding estimates, can provide a more comprehensive description of inbreeding in the turkey genome. This knowledge can be used to evaluate genetic diversity, a requirement for genetic improvement, and develop methods to minimize inbreeding in turkey breeding programs.

Housing and Management of Turkey Flocks in Canada.

An increased understanding of the turkey sector and how farmers manage flocks can help maintain and improve the health and welfare of turkeys. We conducted a cross-sectional survey among turkey farmers in Canada to gain information regarding general farm characteristics, housing aspects (incl. lighting, ventilation), litter management, feed and water management, flock characteristics, and flock health management. The survey was distributed to 500 farmers through the Turkey Farmers of Canada in April-December 2019. A total of 83 final responses (response rate approx. 20%) were used for a descriptive analysis to determine the frequency of housing and management practices (77 commercial flocks, 6 breeder flocks). Hen flocks (n = 53) had a median age of eight weeks (IQR: 7-12 weeks) and tom flocks (n = 30) had a median age of 12 weeks (IQR: 9-14 weeks). Turkey flocks within Canada are typically kept in indoor barn systems on a concrete floor (87.5%), with bedding (e.g., straw, wood shavings) provided (100%). The majority followed a brood and move growing system (68.8%), and a large proportion of farmers indicated that they raised turkeys under the 'Raised Without Antibiotics/Antibiotic Free' or the 'Responsible Use of Antibiotics' certification (70.5%). Possible room for improvement could be found in terms of litter management and biosecurity practices, however, further research is needed to make clear recommendations.

Comparison of electric field enhancements: linear and triangular oligomers versus hexagonal arrays of plasmonic nanospheres.

We investigate local electromagnetic field enhancements in oligomers of plasmonic nanospheres. We first evaluate via full-wave simulations the field between spheres in several oligomer systems: linear dimers, linear trimers, trimers 60°, trimers 90° and linear quadrumers. To gain a better understanding of the field enhancement values, we compare the results with local fields in a hexagonal close-packed (HCP) configuration with same structural dimensions. We then inter-relate the field enhancement values found via full-wave simulations to SERS enhancements of actual fabricated self-assembled oligomers. We find that linear oligomers provide the largest field enhancement values. Finally, we provide closed-form formulas for the prediction of the resonance frequency responsible for field enhancement in linear oligomers, namely dimers, trimers and quadrumers, modeling each nanosphere as a single electric dipole. These formulas provide with resonance values less than 7% shifted when compared to full-wave results even when the gap between spheres is only about one fifth of the radius, showing the powerfulness of dipolar approximations. The results shown in this paper demonstrate that ad hoc clusters of nanospheres can be designed and fabricated to obtain larger field enhancements than with the HCP structure and this may pave the way for the development of improved sensors for molecular spectroscopy.

Directing cluster formation of Au nanoparticles from colloidal solution.

Discrete clusters of closely spaced Au nanoparticles can be utilized in devices from photovoltaics to molecular sensors because of the formation of strong local electromagnetic field enhancements when illuminated near their plasmon resonance. In this study, scalable, chemical self-organization methods are shown to produce Au nanoparticle clusters with uniform nanometer interparticle spacing. The performance of two different methods, namely electrophoresis and diffusion, for driving the attachment of Au nanoparticles using a chemical cross-linker on chemically patterned domains of polystyrene-block-poly(methyl methacrylate) (PS-b-PMMA) thin films are evaluated. Significantly, electrophoresis is found to produce similar surface coverage as diffusion in 1/6th of the processing time with an ~2-fold increase in the number of Au nanoparticles forming clusters. Furthermore, average interparticle spacing within Au nanoparticle clusters was found to decrease from 2-7 nm for diffusion deposition to approximately 1-2 nm for electrophoresis deposition, and the latter method exhibited better uniformity with most clusters appearing to have about 1 nm spacing between nanoparticles. The advantage of such fabrication capability is supported by calculations of local electric field enhancements using electromagnetic full-wave simulations from which we can estimate surface-enhanced Raman scattering (SERS) enhancements. In particular, full-wave results show that the maximum SERS enhancement, as estimated here as the fourth power of the local electric field, increases by a factor of 100 when the gap goes from 2 to 1 nm, reaching values as large as 10(10), strengthening the usage of electrophoresis versus diffusion for the development of molecular sensors.

Non-lithographic SERS substrates: tailoring surface chemistry for Au nanoparticle cluster assembly.

Near-field plasmonic coupling and local field enhancement in metal nanoarchitectures, such as arrangements of nanoparticle clusters, have application in many technologies from medical diagnostics, solar cells, to sensors. Although nanoparticle-based cluster assemblies have exhibited signal enhancements in surface-enhanced Raman scattering (SERS) sensors, it is challenging to achieve high reproducibility in SERS response using low-cost fabrication methods. Here an innovative method is developed for fabricating self-organized clusters of metal nanoparticles on diblock copolymer thin films as SERS-active structures. Monodisperse, colloidal gold nanoparticles are attached via a crosslinking reaction on self-organized chemically functionalized poly(methyl methacrylate) domains on polystyrene-block-poly(methyl methacrylate) templates. Thereby nanoparticle clusters with sub-10-nanometer interparticle spacing are achieved. Varying the molar concentration of functional chemical groups and crosslinking agent during the assembly process is found to affect the agglomeration of Au nanoparticles into clusters. Samples with a high surface coverage of nanoparticle cluster assemblies yield relative enhancement factors on the order of 109 while simultaneously producing uniform signal enhancements in point-to-point measurements across each sample. High enhancement factors are associated with the narrow gap between nanoparticles assembled in clusters in full-wave electromagnetic simulations. Reusability for small-molecule detection is also demonstrated. Thus it is shown that the combination of high signal enhancement and reproducibility is achievable using a completely non-lithographic fabrication process, thereby producing SERS substrates having high performance at low cost.