Postoperative mometasone irrigations improve quality of life in skull base tumor patients

Objectives:The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well studied.We quantified long‐term impact of postoperative steroid irrigations (SIs) on quality of life of patients after ESBS.Methods:Retrospective review of patients at the University of Pennsylvania undergoing ESBS from 2010 to 2019.Data on patient demographics and postoperative treatment with nasal saline irrigation twice daily with and without dissolved steroids (mometasone or budesonide) was collected.Preoperative,and 1‐,3‐,6‐,12‐,18‐,and 24‐month postoperative Sino‐Nasal Outcome Test (SNOT‐22) scores were assessed.Results:A total of 727 patients were assessed (53.4% males),with 479 patients in the no SI group and 248 patients in the SI group.Preoperative SNOT‐22 scores did not differ significantly (P = 0.19).1‐,3‐,6‐,12‐,18‐,and 24‐month post‐op SNOT‐22 scores did not significantly differ between groups.However,mometasone irrigations resulted in significantly lower postoperative 2‐year SNOT‐22 scores compared to budesonide (P < 0.01) and saline (P = 0.03).Conclusions:Though corticosteroid irrigations are routine in managing inflammatory sinus disease,their role in postoperative management after ESBS for tumors is unclear.Our findings suggest that mometasone irrigation may be effective at improving postoperative quality of life in patients after ESBS.

Spectroscopic investigations on Dy^(3+) ions doped zinc lead alumino borate glasses for photonic device applications

This paper presents the structural, optical absorption, photoluminescence (PL) and decay spectral properties of Dy^(3+)ions doped zinc lead alumino borate (ZPAB) glasses to elucidate their possible usage in photonic devices such as w-LEDs and lasers. A broad hump shown by the XRD spectrum recorded for an un-doped ZPAB glass confirms its non-crystalline nature. The Judd-Ofelt (J-O) intensity parameter evaluated from the measured oscillator strengths of the absorption spectral features were used to estimate various radiative parameters and also to understand the nature of bonding between Dy^(3+)ions and oxygen ligands. Under 350 nm excitation, the as-prepared glasses are exhibiting two emission bands^4F_(9/2)→~6H_(15/2)(blue),and^4F_(9/2)→~6H_(13/2)(yellow) at 483 and 575 nm,respectively. From the PL spectra,the Y/B ratio values, CIE chromaticity color coordinates and color correlated temperature (CCT) were evaluated. The experimental lifetimes measured from the decay profiles are decreasing with increase in Dy^(3+)ions concentration in these glasses which may be attributed to the cross-relaxation and nonradiative multiphonon relaxation process. Decay profiles observed for higher concentration were well fitted to Inokuti-Hirayama (I-H) model to understand the energy transfer process and subsequent decrease in experimental lifetimes. The higher values of radiative parameters, emission cross-sections,quantum efficiency, optical gain and gain band width suggest the suitability of 0.5 mol%of Dy^(3+) ions in these ZPAB glasses for the photonic device application.

Implementation of an enhanced recovery after surgery protocol for head and neck cancer patients:Considerations and best practices

Enhanced recovery after surgery(ERAS)protocols have been developed in numerous surgical specialties as a means of systematically improving patient recovery,functional outcomes,cost savings,and resource utilization.Such multidisciplinary initiatives seek to minimize variability in several aspects of perioperative patient care,helping to reduce inpatient length of hospital stay,complications,and the overall resource and financial burden of surgical care.Head and neck oncology patients stand to benefit from the implementation of comprehensive ERAS protocols,as these patients have complex medical needs that may dramatically impact multiple aspects of their recovery,including breathing,eating,nutrition,pain,speech,swallowing,and communication.Implementing ERAS protocols for head and neck cancer patients may present unique challenges,and require significant interdisciplinary coordination and collaboration.We therefore sought to provide a comprehensive guide to the planning and institution of such ERAS systems at institutions undertaking care of head and neck cancer patients.Key elements to consider in the implementation of successful ERAS protocols for this population include organizing a team consisting of frontline leaders such as nursing staff,medical specialists,and associated health professionals;designing interventions based on systematically evaluated,high-quality literature;and instituting a clear methodology for regularly updating protocols and auditing the success or potential limitations of a given intervention.Potential obstacles to the success of ERAS interventions for head and neck cancer patients include challenges in systematically tracking progress of the protocol,as well as resource limitations in a given health system.

Enhanced visible green and 1.5μm radiative emission of Er^(3+)ions in Li_(2)O-PbO-Al_(2)O_(3)-B_(2)O_(3) glasses for photonic applications

A series of Er^(3+)ions doped lithium lead alumino borate(LiPbAlB)glasses were synthesized via melt quench method and their structural,physical and optical properties were studied.Judd-Ofelt theory in correlation with the emission and absorption profiles was performed for the measurement of various radiative parameters for different transitions of Er^(3+)doped glasses.The as-prepared glasses show deep green(550 nm)as well as NIR(1532 nm)emission at 380 and 980 nm excitation wavelengths,respectively.The intensity of emission spectra increases with Er^(3+)ions concentration up to 1.5 mol%and beyond quenching is observed.The Dexter theory applied to the emission profiles reveals the interaction between Er^(3+)ions as dipole-dipole in nature.CIE color coordinates are found to fall in the green region of the visible spectrum.It is observed that 1.5 mol%of Er^(3+)ions concentration is optimum to exhibit the maximum quantum efficiency,branching ratios,gain bandwidth,emission cross-section,gain crosssection and aptly suitable for visible and NIR photonic applications.