Elevated risk of infection with SARS-CoV-2 Beta, Gamma, and Delta variants compared with Alpha variant in vaccinated individuals

The extent to which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) break through infection- or vaccine-induced immunity is not well understood. We analyzed 28,578 sequenced SARS-CoV-2 samples from individuals with known immune status obtained through national community testing in the Netherlands from March to August 2021. We found evidence of an increased risk of infection by the Beta (B.1.351), Gamma (P.1), or Delta (B.1.617.2) variants compared with the Alpha (B.1.1.7) variant after vaccination. No clear differences were found between vaccines. However, the effect was larger in the first 14 to 59 days after complete vaccination compared with ≥60 days. In contrast to vaccine-induced immunity, there was no increased risk for reinfection with Beta, Gamma, or Delta variants relative to the Alpha variant in individuals with infection-induced immunity.</p

Analysis of tracheostoma morphology

Objectives: Existing fixation methods of automatic speaking valves (ASVs) suffer from shortcomings which partly are the result of insufficient conformity of the intratracheal fixation method’s shape to the tracheostoma anatomy. However, quantitative data are lacking and will be helpful to analyse solutions for airtight fixation. This article provides such data. Patients and methods: The tracheostoma morphology was measured in computerized tomography scans of 20 laryngectomized patients. Measured were transverse and sagittal diameters, transition angle between skin level and tracheostoma lumen and between the tracheostoma lumen to the trachea, TE valve placement and stoma depth. Results: The mean transverse and sagittal diameters of the stoma at the peristomal lip are 19.2 mm [standard deviation (SD 5.2 mm)] and 17.6 mm (SD 5.3 mm), respectively. The mean transition angles are 84.5° (SD 15.6°) at skin level and 153.6° (SD 11.7°) into the trachea. The mean distance between TE valve and peristomal lip is 13.5 mm (SD 7.0 mm). The mean stoma depth is 14.0 mm (SD 6.4 mm). Conclusions: Due to the large variation, no ‘average tracheostoma morphology’, suitable for shaping a generic intratracheal fixation device, can be defined. Therefore, providing an airtight fixation in each patient would require a large range of different sizes, customization or a new approach

sEMG-assisted inverse modelling of 3D lip movement: a feasibility study towards person-specific modelling

Abstract We propose a surface-electromyographic (sEMG) assisted inverse-modelling (IM) approach for a biomechanical model of the face to obtain realistic person-specific muscle activations (MA) by tracking movements as well as innervation trajectories. We obtained sEMG data of facial muscles and 3D positions of lip markers in six volunteers and, using a generic finite element (FE) face model in ArtiSynth, performed inverse static optimisation with and without sEMG tracking on both simulation data and experimental data. IM with simulated data and experimental data without sEMG data showed good correlations of tracked positions (0.93 and 0.67) and poor correlations of MA (0.27 and 0.20). When utilising the sEMG-assisted IM approach, MA correlations increased drastically (0.83 and 0.59) without sacrificing performance in position correlations (0.92 and 0.70). RMS errors show similar trends with an error of 0.15 in MA and of 1.10 mm in position. Therefore, we conclude that we were able to demonstrate the feasibility of an sEMG-assisted inverse modelling algorithm for the perioral region. This approach may help to solve the ambiguity problem in inverse modelling and may be useful, for instance, in future applications for preoperatively predicting treatment-related function loss

Adjustable breathing resistance for laryngectomized patients: Proof of principle in a novel heat and moisture exchanger cassette

Background: Due to the heat and moisture exchanger's (HME) breathing resistance, laryngectomized patients cannot always use an (optimal) HME during physical exercise. We propose a novel HME cassette concept with adjustable “bypass,” to provide adjustment between different breathing resistances within one device. Methods: Under standardized conditions, the resistance and humidification performance of a high resistance/high humidification HME (XM) foam in a cassette with and without bypass were compared to a lower resistance/lesser humidification HME (XF) foam in a closed cassette. Results: With a bypass in the cassette, the resistance and humidification performance of XM foam were similar to those of XF foam in the closed cassette. Compared to XM foam in the closed cassette, introducing the bypass resulted in a 40% resistance decrease, whereas humidification performance was maintained at 80% of the original value. Conclusions: This HME cassette prototype allows adjustment between substantially different resistances while maintaining appropriate humidification performances

Five Specific Tongue Movements in a Healthy Population

The importance of tongue mobility on speech, oral food transport, and swallowing is well recognized. However, whether the individual tongue mobility influences postoperative function in oral cancer treatment remains to be elucidated. This study assesses the ability to perform five tongue movements as rolling, twisting (two sides), folding, and the ‘cloverleaf’ in a healthy population. Because a tumor in oral cancer patients often restricts the mobility of the tongue, it might be helpful to know if it is possible to recall any of those movements without demonstrating it. Two observers asked 387 Dutch healthy adults if they could perform one of the five specific tongue movements and were subsequently asked to demonstrate the five movements. The distribution in the Dutch population is: rolling: 83.7%, cloverleaf: 14.7%, folding: 27.5%, twisting left: 36.1% and twisting right: 35.6%. The percentage of people that can fold their tongue is almost ten times higher (3% versus 27.5%) than in previous research, and it was found that the ability to roll the tongue is not a prerequisite for folding of the tongue. A relationship between gender or right-handedness and the ability to perform certain tongue movements could not be found. Of the participants, 9.9% and 13.1% incorrectly assumed that they could demonstrate tongue rolling and cloverleaf. Tongue folding and twisting (left or right) were incorrectly assumed in 36.9%, 24.1%, and 25.4% of the cases. Rolling and cloverleaf are preferred for future prediction models because these movements are easy to recall without demonstrating

Rest pose and seven facial expressions as instructed to the volunteers.

<p>A: rest, B: voluntary smiling, C: pursed lips, D: raised upper lip, E: mouth open, F: depressed mouth corners, G: blowing, H: pouting.</p

The error values for <i>e</i>_<i>c</i> and <i>e</i>_<i>r</i> by volunteer with the mean optimal settings, i.e. volunteer-independent settings (see Eq (16)).

<p>The error values for <i>e</i>_<i>c</i> and <i>e</i>_<i>r</i> by volunteer with the mean optimal settings, i.e. volunteer-independent settings (see Eq (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0175025#pone.0175025.e031" target="_blank">16</a>)).</p

The lowest error values for <i>e</i>_<i>c</i> and <i>e</i>_<i>r</i> by volunteer with the corresponding settings.

<p>The lowest error values for <i>e</i>_<i>c</i> and <i>e</i>_<i>r</i> by volunteer with the corresponding settings.</p