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Objective: To determine the association of social determinants of health (SDOH) on the presentation and management of unilateral vocal fold immobility (UVFI). Methods: Retrospective chart review of 207 adult UVFI patients evaluated at a tertiary‐care hospital between 2018 and 2019 was performed. Sociodemographic factors including gender, median household income, preferred language, and insurance type were recorded. Confounding clinical factors including etiology of UVFI, Voice Handicap Index‐10 (VHI‐10) score, laryngoscopic findings, and intervention history were extracted from medical records. Multivariable logistic regression was performed using sociodemographic and clinical factors. Results: Patient demographics and socioeconomic status were not associated with time to presentation. Patients presenting with glottic insufficiency and UVFI due to malignancy or recurrent laryngeal nerve (RLN) sacrifice had a shorter time to presentation. Higher household income was associated with greater number of interventions (p = 0.02), but neither income nor insurance type affected intervention type or timing. Female patients were less likely to undergo injection medialization laryngoplasty (odds ratio [OR] 0.25, p = 0.005). Older patients were more likely to undergo injection (OR 1.04, p = 0.027). Patients with large glottic gaps (OR 21.2, p = 0.014) and higher VHI‐10 scores (OR 1.06, p = 0.047) were more likely to undergo surgery. Conclusion: Higher household income was associated with greater number of interventions and longer duration of care at a private tertiary‐care hospital. RLN sacrifice, known malignancy, and glottic insufficiency significantly reduced the time to presentation. Type of intervention received was a complex interplay of both demographic and clinical factors. Large prospective studies should examine the role of SDOH in the presentation and management of UVFI. Level of Evidence: 4 Laryngoscope, 134:297–304, 2024 [ABSTRACT FROM AUTHOR]

Objectives: Sequelae of laryngotracheal stenosis (LTS) can be devastating, often necessitating tracheostomy. This study aims to describe the characteristics and outcomes of patients with LTS and identify risk factors for long‐term tracheostomy dependence stratified by etiology. Methods: A retrospective chart review was performed on 215 patients diagnosed with LTS from 09/01/2011 to 12/31/2020. Patients were grouped based on the cause of LTS. Patient factors were compared to evaluate risk factors for long‐term tracheostomy dependence. Results: Of the 215 patients, 129 (60%) were classified as iatrogenic, 41 (19%) idiopathic, 10 (4.7%) cancer treatment, 18 (8.3%) autoimmune, and 17 (8%) patients unknown. Idiopathic patients were significantly less likely to be tracheostomy‐dependent compared with iatrogenic patients (p < 0.001) and cancer patients (p < 0.05). The mortality rate did not significantly differ among the categories (p = 0.1078). Significant improvement was seen after treatment, as the median percent of stenosis at presentation was 52.5%, and the median percent of stenosis at the most recent visit was 10% (p < 0.001). The autoimmune group received the most steroid injections (mean = 6.56; SD = 11.96). The idiopathic group had the longest surgery‐free interval (mean = 30.8 months; SD = 27.7). Conclusion: Iatrogenic and cancer patients were more likely to be tracheostomy‐dependent. There was a significant improvement in percent and length of stenosis after treatment, with the idiopathic group having the longest surgery‐free interval. Mortality risk did not differ among the different etiologies of LTS. Level of Evidence: 3 Laryngoscope, 134:257–263, 2024 [ABSTRACT FROM AUTHOR]

Objective: Compare cochlear implant (CI) outcomes in English speakers, Spanish speakers, and bilingual Hispanics. Study Design: Retrospective review. Setting: Academic tertiary care center. Methods: Eighty‐five postlingually deafened adults unilaterally implanted between January 2014 and December 2018 were stratified by primary language. Primary outcomes were: (1) English consonant‐nucleus‐consonant and Spanish bisyllables word tests in quiet, and (2) English AzBio and Latin American Hearing In Noise Test (LA‐HINT) sentence tests in quiet and in noise at multiple time‐intervals postactivation. Results: In the respective languages, primary Spanish speakers (n = 24), and English speakers (n = 61) experienced the greatest increases in average scores for word and sentence tests in quiet during the first 6 months postactivation, with gradual increases in average scores over time. English speakers performed significantly worse on AzBio tests in noise, compared to quiet, while the addition of noise did not significantly affect average LA‐HINT scores in Spanish speakers across multiple time intervals. An early ceiling effect was also demonstrated for LA‐HINT. Although not significant, bilingual Hispanics (n = 12) had lower average AzBio in quiet scores than English speakers and higher average LA‐HINT in quiet scores than the Spanish speakers across multiple time intervals. Conclusion: English and Spanish CI users experienced the greatest increases in speech understanding in quiet the first few months after implant activation. An early ceiling effect is demonstrated with LA‐HINT, indicating LA‐HINT is not appropriate for evaluating longitudinal CI outcomes in Spanish speakers. Bilingual Hispanics represent a unique group, and further investigations are necessary to understand speech perception patterns in both languages and develop the best CI test strategies for these individuals. [ABSTRACT FROM AUTHOR]

With the development of multi-polarization in the world, the UN Security Council plays an increasingly important role in maintaining international peace and promoting international cooperation, which has attracted much attention from the academic and industrial circles. However, the current structure of five permanent and ten non-permanent members of the Council does not maximize efficiency and legitimacy, making it more difficult to resolve international conflicts on time. This article first has carried on the extensive search for relevant theories and finishing, and on this basis, using the survey method, literature research, interdisciplinary research method, qualitative analysis method, and other research methods. The goal is to balance the efficiency and the legitimacy of the UNSC, especially improving the council’s legitimacy. This paper draws the following conclusions: 1. Increase the number of seats on the Council by twenty-four (five permanent members, eight four-year renewable seats, and 11 non-permanent members) 2. It is impossible to abolish the veto completely, but permanent members should be urged to reduce the use of the veto through legislation. Given the political conflicts of interest and the complexity of revising the UN Charter, governments of all countries should promote internal negotiations as soon as possible, conduct in-depth dialogue and consultation on core major issues, clarify the principles and methods of reform, and determine practical solutions.

Objective: This study aimed to compare the prevalence and incidence of vocal fold pathologies among undergraduate classical, musical theatre, and contemporary commercial music (CCM) students over two‐time points. Methods: This study is part of a longitudinal investigation. Videostroboscopic examinations were rated, with consensus among three of four expert blinded raters confirming the presence of pathology. Association between genre of singer and the presence of pathology, interrater reliability, and intra‐rater reliability were calculated. Prevalence and incidence of pathologies were compared across genres. Results: During first‐year evaluations, 32% of musical theatre, 18% of CCM, and 0% of classical students had vocal pathologies. The prevalence at third‐year evaluations showed 22% of classical, 39% of musical theatre, and 27% of CCM participants having vocal fold pathologies. The incidence of pathologies was 67% of musical theatre students compared to 22% of classical students and 27% of CCM students. The four raters demonstrated fair to moderate interrater agreement. Singing Voice Handicap Index‐10 scores were normal for CCM singers at both time points but elevated for musical theatre and classical singers. Conclusion: No classical singers were found to have pathology during first‐year evaluations, although CCM and musical theatre singers showed evidence of vocal fold pathologies. At third‐year evaluations, all three genres had an apparent increase in prevalence of pathologies. Implications of this study suggest that more time in the field and intense voice usage may lead to a greater risk of pathology for all singers, regardless of genre. Level of Evidence: 2 Laryngoscope, 133:2317–2324, 2023 [ABSTRACT FROM AUTHOR]

A hydrodynamic and acoustic mode decomposition method for velocity and pressure based on Helmholtz decomposition and momentum equation is proposed. It is able to decompose the flow variables of velocity and pressure into their vortical, acoustic, and entropic components. The method is verified and validated by a Mach 0.9 turbulent jet flow. The spectral properties of the decomposed hydrodynamic and acoustic components verify that the method successfully separates the two parts. Spectral proper orthogonal decomposition analysis of the decomposed fields clearly identifies the spatial structures of the first three radial orders trapped waves in the potential core and validates the shallow angle noise generation mechanism of spectral leakage for subsonic wavepacket. The present work provides insights into flow–acoustic interaction and aeroacoustic source identification for turbulent jets. [ABSTRACT FROM AUTHOR]