Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry

Transoral laser microsurgery (TLM) is an emerging technique for the management of laryngeal and other head and neck malignancies. It is increasingly being used in place of traditional open surgery because of lower morbidity and improved organ preservation. Since the surgery is performed from the inside working outward as opposed to working from the outside in, there is less damage to the supporting structures that lie external to the tumor. Coupling the laser to a micromanipulator and a microscope allows precise tissue cutting and hemostasis; thereby improving visualization and precise ablation. The basic approach and principles of performing TLM, the devices currently in use, and the associated dosimetry parameters will be discussed. The benefits of using TLM over conventional surgery, common complications and the different settings used depending on the location of the tumor will also be discussed. Although the CO2 laser is the most versatile and the best-suited laser for TLM applications, a variety of lasers and different parameters are used in the treatment of laryngeal cancer. Improved instrumentation has lead to an increased utilization of TLM by head and neck cancer surgeons and has resulted in improved outcomes. Laser energy levels and spot size are adjusted to vary the precision of cutting and amount of hemostasis obtained

Communication practices in the US and Syria

This study highlights Syrian communication practices using comparative tests with the United States communication as a baseline. Additionally, theoretical findings on individualism and collectivism theory are extended to include findings from Syria. Multivariate Analysis of Covariance was used to test culture’s effect in demographically similar (in age, SES, and education) student convenience samples, with the covariate communication adaptability, on dependent variables: empathy, social confirmation, social composure, friendships, non-verbal immediacy, social self-efficacy, and general self-efficacy. Results indicated that Syrians possess more empathy, social confirmation, and perceived general self-efficacy in comparison to U.S. citizens who have greater social composure, friendships, non-verbal immediacy and social self-efficacy. These results indicate that Syrians have the strength of self-efficacy to succeed in intercultural relationships while U.S. Americans have the assets of warmth and sociability to enable successful interactions with Syrian

The Rates of Postmastectomy Immediate Breast Reconstruction during the Initial Months of the COVID-19 Pandemic.

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic-related changes may have led to changes in immediate breast reconstruction (IBR) rates. We aimed to evaluate these changes before, during, and after the initial wave of COVID-19. METHODS: We retrospectively reviewed women who underwent mastectomy with or without IBR from January 1 to September 30, 2019 and from January 1 to September 30, 2020, and compared demographic, clinical, and surgical variables between defined time periods. RESULTS: A total of 202 mastectomies were included. Fewer patients underwent IBR during the initial surge of COVID-19 (surge period) compared with the months before (presurge period; 38.46% versus 70.97%, CONCLUSIONS: IBR rates were lower even after the initial surge than at the year before. Furthermore, during the pandemic, IBR patients were older, had fewer follow-up visits, and fewer reported complications

An AmI-based and privacy-preserving shopping mall model

Abstract Nowadays, large shopping malls provide tools to help and boost customers to buy products. Some of these tools melt down digital operations with physical ones executed by customers into blended commerce experiences. On the other hand, ambient intelligence (AmI) represents a paradigm focused on equipping physical environments to define ergonomic spaces for people interacting with computer-based localized services which are ubiquitously accessible. In this context, we propose a framework based on cellular automata (CA), a very well known formal computational model, suitable to abstract services deployed into an AmI-based environment preserving certain privacy levels of shoppers’ information. CA-based algorithms are advantageous because they are distributed, scalable, on-line and require low costs to be deployed. This work proposes a recent application of CA, namely Cellular ANTomata, to implement a service by which shoppers are guided to find the suitable offerings for items in their shopping lists. A further result provided by this paper is the instantiation of a protocol for privacy-preserving shopping experience in the shopping mall

Assessment of Forces in Intradermal Injection Devices: Hydrodynamic Versus Human Factors

Abstract: Purpose The force that has to be exerted on the plunger for administering a given amount of fluid in a given time, has an important influence on comfort for the subject and usability for the administrator in intradermal drug delivery. The purpose of this study is to model those forces that are subject-independent, by linking needle and syringe geometry to the force required for ejecting a given fluid at a given ejection rate. Material and Methods We extend the well-known Hagen-Poiseuille formula to predict pressure drop induced by a fluid passing through a cylindrical body. The model investigates the relation between the pressure drop in needles and the theoretic Hagen-Poiseuille prediction and is validated in fifteen needles from 26G up to 33G suited for intradermal drug delivery. We also provide a method to assess forces exerted by operators in real world conditions. Results The model is highly linear in each individual needle with R-square values ranging from 75% up to 99.9%. Ten out of fifteen needles exhibit R-square values above 99%. A proof-of-concept for force assessment is provided by logging forces in operators in real life conditions. Conclusions The force assessment method and the model can be used to pinpoint needle geometry for intradermal injection devices, tuning comfort for subjects and usability for operators