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Objectives: To examine the otolaryngology residency selection process, including past experiences based on the medical literature and survey analysis of our present practices to generate recommendations for future selection system design. Methods: A mixed‐methods study, including a scoping review and a cross‐sectional survey, was completed. Four databases were assessed for articles on otolaryngology residency selection published from January 1, 2016 through December 31, 2020. A 36‐question survey was developed and distributed to 114 otolaryngology program directors. Descriptive and thematic analysis was performed. Results: Ultimately, 67 of 168 articles underwent data abstraction and assessment. Three themes surfaced during the analysis: effectiveness, efficiency, and equity. Regarding the survey, there were 62 participants (54.4% response rate). The three most important goals for the selection process were: (1) to fit the program culture, (2) to make good colleagues, and (3) to contribute to the program's diversity. The three biggest 'pain points' were as follows: (1) Large volume of applications, (2) Lack of reliable information about personal characteristics, and (3) Lack of reliable information about a genuine interest in the program. Conclusions: Within this study, the depth and breadth of the literature on otolaryngology residency selection have been synthesized. Additionally, baseline data on selection practices within our specialty has been captured. With an informed understanding of our past and present, we can look to the future. Built upon the principles of person‐environment fit theory, our proposed framework can guide research and policy discussions regarding the design of selection systems in otolaryngology, as we work to achieve more effective, efficient, and equitable outcomes. Level of evidence: N/A Laryngoscope, 133:2929–2941, 2023 [ABSTRACT FROM AUTHOR]

A description of DNA microarray technology and its potential uses in dentistry is provided. DNA microarrays are small glass slides or silicon chips that contain hundreds and even thousands of pieces of DNA. The DNA binds to messenger RNA from cells, which tells researchers what genes are activated. Thousands of genes from a biopsy sample can be screened simultaneously and quickly.

Objectives: To determine the proportion and relative advancement of women in leadership positions at high-impact otolaryngology journals.Methods: Nine clinical otolaryngology journals were selected based on high impact factor and subspecialty representation (journal impact factor, 2016: 1.16-2.95). The proportion of women editorial board members associate and/or section editors, and/or editor-in-chief was measured from 1997 to 2017. Comparisons were made to the proportion of women otolaryngology faculty at U.S. medical schools in 2017.Results: From 1997 to 2017, female editorial board membership increased from 7.2% (range: 0.0%-12.8%) to 17.7% (range: 10.9%-38.9%) (P = 0.0001). In 2017, the proportion of female editorial board members was significantly less than the proportion of female academic otolaryngology faculty (17.7% vs. 27.7%, P = 0.0001), and there was threefold variation between journals. From 1997 to 2017, the proportion of female associate and/or section editors increased from 9.3% (range: 0.0-27.3) to 20.9% (range: 5.3% to 45.5%) (P = 0.09). In 2017, the proportion of female associate and/or section editors was not significantly different than the proportion of female associate or full professor academic otolaryngology faculty (20.9% vs. 19.5%, P = 0.73), but there was ninefold variation between journals.Conclusion: Women were underrepresented on eight of nine otolaryngology editorial boards but appropriately represented at the associate and/or section editorship level. There was remarkable variation in representation at individual journals, which may provide future opportunities to examine best practices. Disparity exists in leadership at the most senior level of these high-profile otolaryngology journals: none had women editor-in-chiefs.Level Of Evidence: NA Laryngoscope, 129:2031-2035, 2019. [ABSTRACT FROM AUTHOR]

Background Most existing objective surgical motion analysis schemes are limited to structured surgical tasks or recognition of motion patterns for certain categories of surgeries. Analyzing instrumentmotion data with respect to anatomical structures can break the limit, and an anatomical region segmentation algorithm is required for the analysis. Methods An atlas was generated by manually segmenting the skull base into nine regions, including left/right anterior/posterior ethmoid sinuses, frontal sinus, left and right maxillary sinuses, nasal airway, and sphenoid sinus. These regions were selected based on anatomical and surgical significance in skull base and sinus surgery. Six features, including left and right eye center, nasofrontal beak, anterior tip of nasal spine, posterior edge of hard palate at midline, and clival body at foramen magnum, were used for alignment. The B-spline deformable registration was adapted to fine tune the registration, and bony boundaries were automatically extracted for final precision improvement. The resultant deformation field was applied to the atlas, and themotion data were clustered according to the deformed atlas. Results Eight maxillofacial computed tomography scans were used in experiments. One was manually segmented as the atlas. The others were segmented by the proposed method. Motion data were clustered into nine groups for every dataset and outliers were filtered. Conclusions The proposed algorithm improved the efficiency of motion data clustering and requires limited human interaction in the process. The anatomical region segmentations effectively filtered out the portion of motion data that are out of surgery sites and grouped them according to anatomical similarities. [ABSTRACT FROM AUTHOR]

Objective To determine the safety and efficacy of using porous high-density polyethylene (PHDPE) in the repair of orbital defects. Design Retrospective case series. Setting Academic tertiary care trauma center. Patients One hundred seventy patients with orbital defects requiring surgical repair. Intervention Orbital defect repair with PHDPE. Main Outcome Measure Our review documents surgical results and complications associated with the use of PHDPE. Results There was a 6.4% complication rate associated with the use of PHDPE. The infection rate was 1.8%. The persistent orbital malposition rate was 3.5%. The extrusion rate was 0%. Conclusions This report represents the largest case series in the literature using PHDPE for orbital reconstructions. The use of PHDPE resulted in a low complication rate and excellent functional and cosmetic reconstructive results. Because of our success with the use of PHDPE, we have changed our clinical practice to minimize the use of autologous graft material, thereby eliminating donor site morbidity in cases involving orbital reconstruction. [ABSTRACT FROM AUTHOR]

Unlabelled: DNA microarray technology has been used for genome-wide gene expression studies that incorporate molecular genetics and computer science skills on massive levels. The technology permits the simultaneous analysis of tens of thousands of genes for the purposes of gene discovery, disease diagnosis. improved drug development, and therapeutics tailored to specific disease processes.Objective: In this review, the two most common microarray technologies and their potential application to dental research will be discussed. The authors review current articles pertaining to the technologies and analysis of mRNA expression using DNA micro-arrays and its application to dental research. Since many genes contribute to normal functioning, research efforts are moving from the search for a disease specific gene to the understanding of the biochemical and molecular functioning of a variety of genes and how complicated networks of interaction can lead to a disease state, such as oral cancer. With the incorporation of DNA micro-array based research, we can look forward to more accurate diagnosis and surgical treatment/drug-delivery therapy based on an individual patient's genetic profile. [ABSTRACT FROM AUTHOR]

Clinical informatics makes use of anatomical representation-particularly in the form of anatomical terms. But differences and ambiguities in naming anatomical structures and partitioning the body can complicate efforts to interlink anatomical resources and integrate clinical data. To better understand differences in representations of human anatomy, we compare five digital resources: a formal ontology, a terminology, and three 3D graphics applications. Because the graphics applications offer explicit representation of the boundaries and partitions of anatomical structures, they reveal the differences in modeling of anatomy that may not be apparent through text-based representations. The variations in these resources allow us to categorize differences in representations of anatomy and to highlight the importance of this topic in the context of clinical informatics.

Background  Most existing objective surgical motion analysis schemes are limited to structured surgical tasks or recognition of motion patterns for certain categories of surgeries. Analyzing instrument motion data with respect to anatomical structures can break the limit, and an anatomical region segmentation algorithm is required for the analysis. Methods  An atlas was generated by manually segmenting the skull base into nine regions, including left/right anterior/posterior ethmoid sinuses, frontal sinus, left and right maxillary sinuses, nasal airway, and sphenoid sinus. These regions were selected based on anatomical and surgical significance in skull base and sinus surgery. Six features, including left and right eye center, nasofrontal beak, anterior tip of nasal spine, posterior edge of hard palate at midline, and clival body at foramen magnum, were used for alignment. The B-spline deformable registration was adapted to fine tune the registration, and bony boundaries were automatically extracted for final precision improvement. The resultant deformation field was applied to the atlas, and the motion data were clustered according to the deformed atlas. Results  Eight maxillofacial computed tomography scans were used in experiments. One was manually segmented as the atlas. The others were segmented by the proposed method. Motion data were clustered into nine groups for every dataset and outliers were filtered. Conclusions  The proposed algorithm improved the efficiency of motion data clustering and requires limited human interaction in the process. The anatomical region segmentations effectively filtered out the portion of motion data that are out of surgery sites and grouped them according to anatomical similarities.

Prediction of microscopic tumor spread to regional lymph nodes can assist in radiation planning for cancer treatment. However, it is still challenging to predict tumor spread. In this paper, we present a unique approach to modeling how tumor cells disseminate to form regional metastases. This involves leveraging well established knowledge resources and commonly held notions of how cancer spreads. Using patient data, we utilized our approach to create a model of metastasis for the subset of head and neck squamous cell carcinoma that arises in the mucosa of the lateral tongue. The model was created using a training set extracted from the clinical records of 50 patients with tumors of this type who presented to the University of Washington head and tumor board over a three and half year period. The test sets consist of four case series drawn from the literature.

Radiation therapy allows precision targeting of certain groups of lymph nodes and is a treatment for metastatic head and neck squamous cell carcinoma. In current practice, there is approximately 15% probability that physicians inadvertently treat healthy tissue or leave the cancerous lymph nodes untreated. The aim of this work is to improve the accuracy of medical decision-making by extending existing predictive models to capture the probabilities of finding cancerous lymph nodes at each of the six image-based surgical neck level using a patient's genetic profile, primary tumor site and tumor size. Our model was trained with publicly available data extracted from the Cancer Genome Atlas (TCGA) and validated against the TCGA dataset both with and without genetic information. Results show that genetic profile data improves model accuracy. These findings suggest that our predictive model may improve the accuracy of clinical decision-making, especially for patients with more advanced metastasis. However, more data is needed to ensure significance of the proposed effects, as well as to improve accuracy of the overall model.

Constructing a biological model using an established ontology provides a unique opportunity to perform content auditing on the ontology. We built a Markov chain model to study tumor metastasis in the regional lymphatics of patients with head and neck squamous cell carcinoma (HNSCC). The model attempts to determine regions with high likelihood for metastasis, which guides surgeons and radiation oncologists in selecting the boundaries of treatment. To achieve consistent anatomical relationships, the nodes in our model are populated using lymphatic objects extracted from the Foundational Model of Anatomy (FMA) ontology. During this process, we discovered several classes of inconsistencies in the lymphatic representations within the FMA. We were able to use this model building opportunity to audit the entities and connections in this region of interest (ROI). We found five subclasses of errors that are computationally detectable and resolvable, one subclass of errors that is computationally detectable but unresolvable, requiring the assistance of a content expert, and also errors of content, which cannot be detected through computational means. Mathematical descriptions of detectable errors along with expert review were used to discover inconsistencies and suggest concepts for addition and removal. Out of 106 organ and organ parts in the ROI, 8 unique entities were affected, leading to the suggestion of 30 concepts for addition and 4 for removal. Out of 27 lymphatic chain instances, 23 were found to have errors, with a total of 32 concepts suggested for addition and 15 concepts for removal. These content corrections are necessary for the accurate functioning of the FMA and provide benefits for future research and educational uses.

Objective: To determine the safety and efficacy of using porous high-density polyethylene (PHDPE) in the repair of orbital defects., Design: Retrospective case series., Setting: Academic tertiary care trauma center. Patients One hundred seventy patients with orbital defects requiring surgical repair. Intervention Orbital defect repair with PHDPE. Main Outcome Measure Our review documents surgical results and complications associated with the use of PHDPE., Results: There was a 6.4% complication rate associated with the use of PHDPE. The infection rate was 1.8%. The persistent orbital malposition rate was 3.5%. The extrusion rate was 0%., Conclusions: This report represents the largest case series in the literature using PHDPE for orbital reconstructions. The use of PHDPE resulted in a low complication rate and excellent functional and cosmetic reconstructive results. Because of our success with the use of PHDPE, we have changed our clinical practice to minimize the use of autologous graft material, thereby eliminating donor site morbidity in cases involving orbital reconstruction.

DNA microarrays are powerful tools for exploring gene expression and predicting disease state. However, since the number of variables (genes) typically exceeds the number of samples (tissue specimens), many potentially spurious genes may be selected for a predictor function. Principle component analysis (PCA) can greatly reduce the high-dimensional microarray data space while retaining most of the inherent variability. We propose a methodology that uses PCA to identify a predictor vector between two mutually exclusive and collectively exhaustive classes. By projecting the training set upon this vector a distribution of projections can be computed for each class. A log-likelihood ratio is then calculated for class membership. We used this methodology to classify 48 biopsy specimens as either oral squamous cell carcinoma or normal oral mucosa using oligonucleotide microarrays. The system was trained using a set of half the samples, and correctly predicted the membership of the other half. The three most highly positively and three most highly negative predictive genes were all keratins that are known markers of squamous cell carcinoma.

We developed a novel method for the discovery of functional relationships between pairs of genes based on gene expression profiles generated from microarrays. This approach examines all possible pairs of genes and identifies those in which the relationship between the two genes changes in different diseases or conditions. In contrast to previous methods that have focused on differentially expressed genes, this method attempts to find changes in the correlation between genes. These changes may be indicative of the functional relationships related to a disease mechanism. We demonstrate the utility of this approach by applying it to an oral squamous cell carcinoma (OSCC) microarray data set. Our results suggest new directions for future experimental investigations.