Observations of the Vertical Structure of Tidal Currents in Two Inlets

Observations of the vertical structure of broad band tidal currents were obtained at two energetic inlets. Each experiment took place over a 4 week period, the first at Hampton Inlet in southeastern New Hampshire, USA, in the Fall of 2011, and the second at New River Inlet in southern North Carolina, USA, in the spring of 2012. The temporal variation and vertical structure of the currents were observed at each site with 600 kHz and 1200 kHz RDI Acoustic Doppler Current Profilers (ADCP) deployed on low-profile bottom tripods in 7.5 and 12.5 m water depths near the entrance to Hampton Inlet, and in 8 and 9 m water depth within and outside New River Inlet, respectively. In addition, a Nortek Aquapro ADCP was mounted on a jetted pipe in about 2.5 m water depth on the flank of the each inlet channel. Flows within the Hampton/Seabrook Inlet were dominated by semi-diurnal tides ranging 2.5 - 4 m in elevation, with velocities exceeding 2.5 m/s. Flows within New River inlet were also semi-diurnal with tides ranging about 1 – 1.5 m in elevation and with velocities exceeding 1.5 m/s. Vertical variation in the flow structure at the dominant tidal frequency are examined as a function of location within and near the inlet. Outside the inlet, velocities vary strongly over the vertical, with a nearly linear decay from the surface to near the bottom. The coherence between the upper most velocity bin and the successively vertically separated bins drops off quickly with depth, with as much as 50% coherence decay over the water column. The phase relative to the uppermost velocity bin shifts over depth, with as much as 40 deg phase lag over the vertical, with bottom velocities leading the surface. Offshore, rotary coefficients indicate a stable ellipse orientation with rotational directions consistent over the vertical. At Hampton, the shallower ADCP, but still outside the inlet, shows a rotational structure that changes sign in the vertical indicating a sense of rotation at the bottom that is opposite to that at the surface. Within the inlet, the flow is more aligned with the channel, the decay in amplitude over the vertical is diminished, the coherence and phase structure is nearly uniform, and the rotary coefficients indicate no sense of rotation in the flow. The observations are qualitatively consistent with behavior described by Prandle (1982) for shallow water tidal flows

Image-guided fluorescence tomography in head & neck surgical models

Clinical indications for fluorescence-guided surgery continue to expand, and are being spurred by the rapid development of new agents that improve biological targeting.1 There is a corresponding need to develop imaging systems that quantify fluorescence - not only at the tissue surface, but at depth. We have recently described an image-guided fluorescence tomography system that leverages geometric data from intraoperative cone-beam CT and surgical navigation,2 and builds on finite-element method software (NIRFAST) for diffuse optical tomography (DOT).3 DOT systems have most commonly been used for sub-surface inclusions buried within tissue (e.g., breast and neurological tumors). Here, we focus on inclusion models relevant to tumors infiltrating from the mucosal surface (an “iceberg” model), as is most often the case in head and neck cancer, where over 85% of tumors are squamous cell carcinoma.4 This work presents results from simulations, tissue-simulating anatomical phantoms, and animal studies involving infiltrative tumor models. The objective is to characterize system performance across a range of inclusion diameters, depths, and optical properties. For example, Fig. 1 shows a fluorescence reconstruction of a simulated tonsil tumor in an oral cavity phantom. Future clinical studies are necessary to assess in vivo performance and intraoperative workflow. Please click Additional Files below to see the full abstract

Assessment of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire for use in patients after neck dissection for head and neck cancer

BackgroundIn this cross‐sectional study, the sensibility, test‐retest reliability, and validity of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire were assessed in patients who underwent neck dissection.MethodsSensibility was assessed with a questionnaire. Test‐retest reliability was performed with completion of the DASH questionnaire 2 weeks after initial completion; validity, by evaluating differences in scores between patients undergoing different types of neck dissections and correlating DASH scores with Neck Dissection Impairment Index (NDII) scores.ResultsThe DASH questionnaire met sensibility criteria. For test‐retest reliability analysis, the intraclass coefficient was 0.91. The DASH questionnaire showed differences between patients who underwent accessory nerve‐sacrifice and nerve‐sparing neck dissection. DASH questionnaire scores strongly correlated with NDII scores (r = ‐0.86).ConclusionAlthough this study provides preliminary data on some psychometric properties of the DASH questionnaire in patients who have undergone a neck dissection, further assessment of responsiveness and other properties are required. © 2014 Wiley Periodicals, Inc. Head Neck 37: 234‐242, 2015Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110617/1/hed23593.pd

Production of tongue twisters by speakers with partial glossectomy

Bressmann T, Foltz A, Zimmermann J, Irish JC. Production of tongue twisters by speakers with partial glossectomy. Clinical Linguistics & Phonetics. 2014;28(12):951-964.A partial glossectomy can affect speech production. The goal of this study was to investigate the effect of the presence of a tumour as well as the glossectomy surgery on the patients' production of tongue twisters with the sounds [t] and [k]. Fifteen patients with tongue cancer and 10 healthy controls took part in the study. The outcome measures were the patients' speech acceptability, rate of errors, the time needed to produce the tongue twisters, pause duration between item repetitions and the tongue shape during the production of the consonants [t] and [k] before and after surgery. The patients' speech acceptability deteriorated after the surgery. Compared to controls, the patients' productions of the tongue twisters were slower but not more errorful. Following the surgery, their speed of production did not change, but the rate of errors was higher. Pause duration between items was longer in the patients than in the controls but did not increase from before to after surgery. Analysis of the patients' tongue shapes for the productions of [t] and [k] indicated a higher elevation following the surgery for the patients with flap reconstructions. The results demonstrated that the surgical resection of the tongue changed the error rate but not the speed of production for the patient. The differences in pause duration also indicate that the tumour and the surgical resection of the tongue may impact the phonological planning of the tongue twister

Programmed cell death 4 loss increases tumor cell invasion and is regulated by miR-21 in oral squamous cell carcinoma

<p>Abstract</p> <p>Background</p> <p>The tumor suppressor Programmed Cell Death 4 (<it>PDCD4</it>) has been found to be under-expressed in several cancers and associated with disease progression and metastasis. There are no current studies characterizing PDCD4 expression and its clinical relevance in Oral Squamous Cell Carcinoma (OSCC). Since nodal metastasis is a major prognostic factor in OSCC, we focused on determining whether PDCD4 under-expression was associated with patient nodal status and had functional relevance in OSCC invasion. We also examined <it>PDCD4 </it>regulation by microRNA 21 (miR-21) in OSCC.</p> <p>Results</p> <p><it>PDCD4 </it>mRNA expression levels were assessed in 50 OSCCs and 25 normal oral tissues. <it>PDCD4 </it>was under-expressed in 43/50 (86%) OSCCs, with significantly reduced mRNA levels in patients with nodal metastasis (<it>p = 0.0027</it>), and marginally associated with T3-T4 tumor stage (<it>p = 0.054</it>). PDCD4 protein expression was assessed, by immunohistochemistry (IHC), in 28/50 OSCCs and adjacent normal tissues; PDCD4 protein was absent/under-expressed in 25/28 (89%) OSCCs, and marginally associated with nodal metastasis (<it>p = 0.059</it>). A matrigel invasion assay showed that PDCD4 expression suppressed invasion, and siRNA-mediated PDCD4 loss was associated with increased invasive potential of oral carcinoma cells. Furthermore, we showed that miR-21 levels were increased in PDCD4-negative tumors, and that <it>PDCD4 </it>expression may be down-regulated in OSCC by direct binding of miR-21 to the 3'UTR <it>PDCD4 </it>mRNA.</p> <p>Conclusions</p> <p>Our data show an association between the loss of PDCD4 expression, tumorigenesis and invasion in OSCC, and also identify a mechanism of PDCD4 down-regulation by microRNA-21 in oral carcinoma. PDCD4 association with nodal metastasis and invasion suggests that PDCD4 may be a clinically relevant biomarker with prognostic value in OSCC.</p

Perioperative pain management and opioid-reduction in head and neck endocrine surgery: An American Head and Neck Society Endocrine Surgery Section consensus statement

BACKGROUND: This American Head and Neck Society (AHNS) consensus statement focuses on evidence-based comprehensive pain management practices for thyroid and parathyroid surgery. Overutilization of opioids for postoperative pain management is a major contributing factor to the opioid addiction epidemic however evidence-based guidelines for pain management after routine head and neck endocrine procedures are lacking. METHODS: An expert panel was convened from the membership of the AHNS, its Endocrine Surgical Section, and ThyCa. An extensive literature review was performed, and recommendations addressing several pain management subtopics were constructed based on best available evidence. A modified Delphi survey was then utilized to evaluate group consensus of these statements. CONCLUSIONS: This expert consensus provides evidence-based recommendations for effective postoperative pain management following head and neck endocrine procedures with a focus on limiting unnecessary use of opioid analgesics

The Impact of Climate Change on Virginia\u27s Coastal Areas

As part of HJ47/SJ47 (2020), the Virginia General Assembly directed the Joint Commission on Technology and Science (JCOTS) to study the “safety, quality of life, and economic consequences of weather and climate-related events on coastal areas in Virginia.” In pursuit of this goal, the commission was to “accept any scientific and technical assistance provided by the nonpartisan, volunteer Virginia Academy of Science, Engineering, and Medicine (VASEM). VASEM convened an expert study board with representation from the Office of the Governor, planning district commissions in coastal Virginia, The Port of Virginia, the Virginia Economic Development Partnership, state universities, private industry, and law firms. In producing the report, the board followed methods similar to those used by the National Academies of Science, Engineering, and Medicine by convening an expert committee tasked with studying and reporting on the topic. As a result, the report represents the views and perspectives of the study board members but was not submitted for public review or comment. This report is the product of those efforts. It finds that climate change will have an increasingly disruptive effect on people living in Virginia’s coastal areas during the 21st century — and that these disruptions will have repercussions across the Commonwealth. It includes an explanation of the physical forces driving climate change, an analysis of the current and projected effects of climate change on the Commonwealth, perspectives that legislators might consider as they face these challenges, and recommendations that could help Virginia implement more productive and effective strategies to address them

American Head and Neck Society Endocrine Section clinical consensus statement: North American quality statements and evidence‐based multidisciplinary workflow algorithms for the evaluation and management of thyroid nodules

BackgroundCare for patients with thyroid nodules is complex and multidisciplinary, and research demonstrates variation in care. The objective was to develop clinical guidelines and quality metrics to reduce unwarranted variation and improve quality.MethodsMultidisciplinary expert consensus and modified Delphi approach. Source documents were workflow algorithms from Kaiser Permanente Northern California and Cancer Care of Ontario based on the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer.ResultsA consensus‐based, unified preoperative, perioperative, and postoperative workflow was developed for North American use. Twenty‐one panelists achieved consensus on 16 statements about workflow‐embedded process and outcomes metrics addressing safety, access, appropriateness, efficiency, effectiveness, and patient centeredness of care.ConclusionA panel of Canadian and United States experts achieved consensus on workflows and quality metric statements to help reduce unwarranted variation in care, improving overall quality of care for patients diagnosed with thyroid nodules.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148340/1/hed25526_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148340/2/hed25526.pd

Development and validation of a Surgical Prioritization and Ranking Tool and Navigation Aid for Head and Neck Cancer (SPARTAN‐HN) in a scarce resource setting: Response to the COVID‐19 pandemic

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163412/2/cncr33114_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163412/1/cncr33114.pd