Penetrating soft palate injury by lollypop candy stick

Incidents of soft palate injury or laceration caused by unintended movement when holding a sharp object in the mouth in the pediatric population are usually rarely reported.Here we report a case of soft palate laceration in a child due to a lollypop stick tip.

Numerical simulation of soft palate movement and airflow in human upper airway by fluid-structure interaction method

In this paper, the authors present airflow field characteristics of human upper airway and soft palate movement attitude during breathing. On the basis of the data taken from the spiral computerized tomography images of a healthy person and a patient with Obstructive Sleep Apnea-Hypopnea Syndrome （OSAHS）, three-dimensional models of upper airway cavity and soft palate are reconstructed by the method of surface rendering. Numerical simulation is performed for airflow in the upper airway and displacement of soft palate by fluid-structure interaction analysis. The reconstructed threedimensional models precisely preserve the original configuration of upper airways and soft palate. The results of the pressure and velocity distributions in the airflow field are quantitatively determined, and the displacement of soft palate is presented. Pressure gradients of airway are lower for the healthy person and the airflow distribution is quite uniform in the case of free breathing. However, the OSAHS patient remarkably escalates both the pressure and velocity in the upper airway, and causes higher displacement of the soft palate. The present study is useful in revealing pathogenesis and quantitative mutual relationship between configuration and function of the upper airway as well as in diagnosingdiseases related to anatomical structure and function of the upper airway.

Evaluation of Airway Obstruction at Soft Palate Level in Male Patients with Obstructive Sleep Apnea/Hypopnea Syndrome:Dynamic 3-Dimensional CT Imaging of Upper Airway

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome（OSAHS） by using dynamic 3-Dimensional（3-D） CT imaging.A total of 41 male patients who presented with 2 of the following symptoms,i.e.,daytime sleepiness and fatigue,frequent snoring,and apnea with witness,were diagnosed as having OSAHS.They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller＇s maneuver.The soft palate length（SPL）,the minimal cross-sectional area of the retropalatal region（mXSA-RP）,and the vertical distance from the hard palate to the upper posterior part of the hyoid（hhL） were compared between the two breathing states.These parameters,together with hard palate length（HPL）,were also compared between mild/moderate and severe OSAHS groups.Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index（AHI） and the lowest saturation of blood oxygen（LSaO2）] was examined.The results showed that 31 patients had severe OSAHS,and 10 mild/moderate OSAHS.All the patients had airway obstruction at soft palate level.mXSA-RP was significantly decreased and SPL remarkably increased during Muller＇s maneuver as compared with the quiet breathing state.There were no significant differences in these airway parameters（except the position of the hyoid bone） between severe and mild/moderate OSAHS groups.And no significant correlation between these airway parameters and the severity of OSAHS was found.The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group.The patients in group with body mass index（BMI）≥26 had higher collapse ratio of mXSA-RP,greater neck circumference and smaller mXSA-RP in the Muller＇s maneuver than those in group with BMI26（P0.05 for all）.It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients.All the OSAHS patients had airway obstruction of various degrees at soft palate level.But no correlation was observed between the airway change at soft palate level and the severity of OSAHS.The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI26.

Expiratory Upper Airway Obstruction Caused by the Soft Palate during Bag-Mask Ventilation

Introduction: Expiratory upper airway obstruction during bag-mask ventilation is not well characterized. Methods: An audit was done to assess expiratory obstruction in 90 adult surgical patients undergoing bag-mask ventilation during the induction of general anaesthesia. Results: Clinicians experienced difficulty delivering gas to the lungs when the head was neutral in 52 of 90 patients (58%;inspiratory obstruction) but this problem was corrected by head tilt and chin lift in all but 2 patients. Clinicians experienced difficulty recovering gas from the lungs when the mouth was held closed under the mask in 30 of the remaining 88 patients (34%;expiratory obstruction). This problem persisted despite head tilt and chin lift in all but one patient but was uniformly corrected by opening the mouth. Inspection of the soft palate revealed that it was lying on the posterior pharyngeal wall in 27 of 30 patients with expiratory obstruction and that the retropalatal space was patent in 55 of 58 patients without expiratory obstruction (χ2, P < 0.001). The clinical predictors of expiratory upper airway obstruction included advanced age, large tongue, and large uvula. Conclusion: Expiratory airway obstruction should be suspected in all cases of difficult mask ventilation that cannot be corrected by head tilt and chin lift. Simply allowing the mouth to open between positive pressure breaths will permit gas to exit the lungs.

Clinical observation of soft palate-pharyngoplasty in the treatment of obstructive sleep apnea hypopnea syndrome in children

BACKGROUND Childhood obstructive sleep apnea hypopnea syndrome(OSAHS)is a common clinical disease that can cause serious complications if not treated in time.The preferred treatment for OSAHS in children is surgery.AIM To observe the effects of soft palate-pharyngoplasty on postoperative outcome,pharyngeal formation,and possible complications.METHODS A total of 150 children with snoring,hernia,and mouth breathing were selected.A polysomnography test was performed to confirm the diagnosis of OSAHS.The children were randomly divided into experimental and control groups.The experimental group underwent adenoidectomy,tonsillectomy,and soft palatepharyngoplasty.The control group underwent adenoidectomy and tonsillectomy.The t-test and chi-square test were used to compare conditions such as postoperative fever,postoperative hemorrhage,and pharyngeal reflux.Postoperative efficacy and complications were interrogated and observed in the form of outpatient follow-up and telephone follow-up at 6 mo and 1 year after surgery.The curative effects were divided into two groups:Cure(snoring,snoring symptoms disappeared)and non-cure.RESULTS The effective rate of the experimental group was significantly higher than that of the control group,but the difference was not statistically significant(P>0.05).The incidence of postoperative bleeding was lower in the experimental group.There was no postoperative pharyngeal reflux in either group.In the experimental group,the incidence of hyperthermia(body temperature exceeded 38.5°C)was lower than that in the control group.The difference in postoperative swallowing pain scores between the experimental and control groups was significant.CONCLUSION Soft palate-pharyngoplasty can more effectively enlarge the anteroposterior diameter and transverse diameter of the isthmus faucium.Compared with surgery alone,it can better treat OSAHS in children,improve the curative effect,reduce the risk of perioperative bleeding,close the surgical cavity,reduce the risk of postoperative infection,reduce the proportion of postoperative fever,and accelerate healing.Although this process takes more time,it is simple,safe,and effective.

Kimura's disease in soft palate with clinical and histopathological presentation: A case report

BACKGROUND Kimura’s disease is an inflammatory disease that is usually found in the deep lymph nodes of the head and neck.While rare,It is most frequently seen in young men.The oral cavity and salivary glands may also be involved.There are no reports on tumor occurring in soft palate.We have encountered a case of Kimura’s disease in the soft palate of an elderly woman.CASE SUMMARY A 63-year-old elderly Chinese woman with a slowly growing mass in the upper jaw was referred to our service.A biopsy to the mass was taken after the patient was referred to our service.The tumor was diagnosed as benign.We performed cervical lymph node puncture and partial surgical excision of the lesion.The tumor,which showed signs of marked follicular hyperplasia with follicles surrounded by eosinophils and lymphocytes,was located within the soft palate.Kimura’s disease was diagnosed after histopathologic examination of the resected tissue.The etiology of Kimura’s disease is not fully understood.One current model includes T-cells involvement with cytokines also playing a role.The patient was without evidence for recurrence of partially resected area 6 mo later.This report shows that Kimura’s disease is not limited to the head,neck,and salivary gland lymph nodes.We present a case of a tumor in soft palate.This location adds another possible site for consideration during the differential diagnoses of a slowly growing mass.CONCLUSION The present case illustrates a characteristic description of Kimura’s disease.This case highlights the main differences between Kimura’s disease and angiolymphoid hyperplasia with eosinophilia.

Assessment of alveolar defect volume in unilateral cleft lip and palate patients using a free software program

The purpose of this study was to assess the alveolar defect volume in unilateral cleft lip and palate (UCLP) subjects using computed tomography (CT) and a free software program to evaluate the intra- and inter-rater measurements, and to compare the cleft volume between age and affected side. The sample of this retrospective study consisted of 20 UCLP individuals, 12 boys and 8 girls, mean age 10.3 ± 2.4 years at the beginning of orthodontic treatment. All subjects required alveolar bone grafting. CT scans of the cleft area were obtained prior to secondary bone grafting, and were analyzed using Image J. software program. The cleft volume was calculated based on axial cross-sectional CT images by two raters (orthodontist and radiologist) and by the same rater (orthodontist) at two different moments. Linear mixed model, Bland-Altman, Pearson’s and intraclass correlation coefficient (ICC) were used. The mean cleft volume was 7.53 ± 1.55 mm3. The intra- and inter-rater measurements were reproducible (ICC = 0.976 and 0.963, respectively) with no significant difference between them. There were no statistically significant differences in the cleft volume related to age or cleft location. The assessment of cleft volume in UCLP using CT images and a free software program was a reproducible method. There was no significant relation between alveolar defect volume and age or cleft location.

Direct 4D printing of functionally graded hydrogel networks for biodegradable,untethered,and multimorphic soft robots

Recent advances in functionally graded additive manufacturing(FGAM)technology have enabled the seamless hybridization of multiple functionalities in a single structure.Soft robotics can become one of the largest beneficiaries of these advances,through the design of a facile four-dimensional(4D)FGAM process that can grant an intelligent stimuli-responsive mechanical functionality to the printed objects.Herein,we present a simple binder jetting approach for the 4D printing of functionally graded porous multi-materials(FGMM)by introducing rationally designed graded multiphase feeder beds.Compositionally graded cross-linking agents gradually form stable porous network structures within aqueous polymer particles,enabling programmable hygroscopic deformation without complex mechanical designs.Furthermore,a systematic bed design incorporating additional functional agents enables a multi-stimuli-responsive and untethered soft robot with stark stimulus selectivity.The biodegradability of the proposed 4D-printed soft robot further ensures the sustainability of our approach,with immediate degradation rates of 96.6%within 72 h.The proposed 4D printing concept for FGMMs can create new opportunities for intelligent and sustainable additive manufacturing in soft robotics.

Pleomorphic Adenoma of the Hard and Soft Palate: A Case Presentation and Literature Review of Minor Salivary Gland Neoplasms

Introduction: Minor salivary gland tumors are relatively rare, but have a higher chance of malignancy than major salivary gland tumors. The palate appears to be the most commonly involved site. The most frequent benign tumor is the pleomorphic adenoma. Case report: We report a case of a pleomorphic adenoma, which occurred in the hard and soft palate of a 34-year-old female and presented as an asymptomatic slow growing, painless mass. The patient was successfully treated with surgical excision. Discussion: Minor salivary gland tumors should be considered in the differential diagnosis of oral cavity and especially palate tumors. A histological examination is necessary due to the high percentage of malignancy.

Obstructive Tumor of the Palate in the Old Person: A Case Report

Introduction: Pleomorphic adenoma or mixed salivary gland tumor is a heterogeneous benign tumor of the salivary glands. The most common site is the parotid gland. Its extra-parotid locations, particularly in the accessory salivary glands, are rarer. We report a case of a pleomorphic adenoma of the posterior palate which posed management problems. Observation: This is an 85-year-old patient who consulted for a tumor of the posterior palate that had been evolving for 3 years. The examination revealed a globular tumor of the posterior palate extending beyond the midline by approximately 7 cm in long axis, shooting towards the oropharynx and hindering breathing, speech and eating, indicating a life-saving tracheotomy. A CT scan of the facial area revealed a well-circumscribed tumor at the expense of the soft palate, with multiple sites of bone lysis. The biopsy performed was in favor of a pleomorphic adenoma. The patient underwent total surgical excision of a huge tumor on the palate. The aftermath of the operation was marked by a loosening of the sutures with an oronasal fistula requiring the creation of an obturator plate due to the patient’s refusal to have another operation. Conclusion: Large pleomorphic adenoma of the posterior palate is a rare entity that can cause respiratory problems and surgical difficulties. His prognosis is generally good.

Some Mixed Soft Operations and Extremally Soft Disconnectedness via Two Soft Topologies

In this paper, we study the concept of soft sets which is introduced by Molodtsov [5]. We give the definition of (τ1,τ2)-semi open soft (resp. (τ1,τ2)-pre open soft, (τ1,τ2)-α-open soft, (τ1,τ2)-β-open soft, (τ1,τ2)'-semi open soft, (τ1,τ2)'-pre open soft, (τ1,τ2)'-α-open soft, (τ1,τ2)'-βopen soft) set via two soft topologies. Also we introduce (τ1,τ2)-regular open soft and ESDC on two soft topologies. The aim of this paper is to investigate properties of some mixed soft operations and characterizations of ESDC. Finally, we study τ2-ESDC soft topologies τ1.

MXenes for Bioinspired Soft Actuators:Advancements in Angle-Independent Structural Colors and Beyond

Soft actuators have garnered substantial attention in current years in view of their potential appliances in diverse domains like robotics,biomedical devices,and biomimetic systems.These actuators mimic the natural movements of living organisms,aiming to attain enhanced flexibility,adaptability,and versatility.On the other hand,angle-independent structural color has been achieved through innovative design strategies and engineering approaches.By carefully controlling the size,shape,and arrangement of nanostructures,researchers have been able to create materials exhibiting consistent colors regardless of the viewing angle.One promising class of materials that holds great potential for bioinspired soft actuators is MXenes in view of their exceptional mechanical,electrical,and optical properties.The integration of MXenes for bioinspired soft actuators with angle-independent structural color offers exciting possibilities.Overcoming material compatibility issues,improving color reproducibility,scalability,durability,power supply efficiency,and cost-effectiveness will play vital roles in advancing these technologies.This perspective appraises the development of bioinspired MXene-centered soft actuators with angleindependent structural color in soft robotics.

An Intelligent MCGDM Model in Green Suppliers Selection Using Interactional Aggregation Operators for Interval-Valued Pythagorean Fuzzy Soft Sets

Green supplier selection is an important debate in green supply chain management(GSCM),attracting global attention from scholars,especially companies and policymakers.Companies frequently search for new ideas and strategies to assist them in realizing sustainable development.Because of the speculative character of human opinions,supplier selection frequently includes unreliable data,and the interval-valued Pythagorean fuzzy soft set(IVPFSS)provides an exceptional capacity to cope with excessive fuzziness,inconsistency,and inexactness through the decision-making procedure.The main goal of this study is to come up with new operational laws for interval-valued Pythagorean fuzzy soft numbers(IVPFSNs)and create two interaction operators-the intervalvalued Pythagorean fuzzy soft interaction weighted average(IVPFSIWA)and the interval-valued Pythagorean fuzzy soft interaction weighted geometric(IVPFSIWG)operators,and analyze their properties.These operators are highly advantageous in addressing uncertain problems by considering membership and non-membership values within intervals,providing a superior solution to other methods.Moreover,specialist judgments were calculated by the MCGDM technique,supporting the use of interaction AOs to regulate the interdependence and fundamental partiality of green supplier assessment aspects.Lastly,a statistical clarification of the planned method for green supplier selection is presented.

Skin and Soft Tissue Infections in the Surgical Area at the Kara Teaching Hospital

Objective: To report the management of skin and soft tissue infections in the surgical area of Kara University Hospital in Togo. Material and Methods: This study was conducted retrospectively from January 1, 2021, to December 31, 2022, in the general surgery and orthopedic trauma departments. The study focused on soft tissue infections of the pelvic and thoracic limbs and analyzed epidemiological, clinical, paraclinical, therapeutic, and evolutionary data. Results: We registered 165 patients, comprising 109 men and 56 women.The sex ratio (F/H) were 0.51. The mean age was 45 years with extremes ranging from 23 to 90 years. Farmers (64.8%) followed by housewives (34.0%) were the social strata most affected. The consultation period varied between 1 and 90 days. The pathologies found were necrotizing fasciitis (53.3%), erysipelas (18.2%), infected limb wounds (12.1%), pyomyositis (9.7%), and necrotizing dermo-hypodermitis (1.8%). The main procedures performed were necrosectomy and grafting (62.9%), sample necrosectomy (18.8%), drainage (9.7%), and pelvic limb amputation (1.2%). Follow-up was favorable in 86.7% of cases. The study noted a death rate of 13.3% due to septic shock secondary to a delay in consultation. Conclusion: Skin and soft tissue infections were a common reason for surgical hospitalization at Kara University Hospital, with a high mortality rate due to delayed consultations.

Einstein Hybrid Structure of q-Rung Orthopair Fuzzy Soft Set and Its Application for Diagnosis of Waterborne Infectious Disease

This research is devoted to diagnosing water-borne infectious diseases caused by floods employing a novel diagnosis approach,the Einstein hybrid structure of q-rung orthopair fuzzy soft set.This approach integrates parts of fuzzy logic and soft set theory to develop a robust alternative for disease detection in stressful situations,especially in areas affected by floods.Compared to the traditional intuitionistic fuzzy soft set and Pythagorean fuzzy soft set,the q-rung orthopair fuzzy soft set(q-ROFSS)adequately incorporates unclear and indeterminate facts.The major objective of this investigation is to formulate the q-rung orthopair fuzzy soft Einstein hybrid weighted average(q-ROFSEHWA)operator and its specific characteristics.Moreover,our stated operator is implementing intelligentmulti-criteria group decision-making(MCGDM)methodology.Floods are severe natural catastrophes that raise the risk of diseases and epidemics,particularly those caused by contaminants in the water,such as gastrointestinal diseases,respiratory infections,vector-borne diseases,skin infections,and water-borne parasites.The designed MCGDM strategy tackles the prevalence of certain conditions in flood-affected patients.A comparative investigation determined that the suggested method for detecting water-borne infectious disease due to floods is more effective and productive than conventional methods because of its logical structure.

GRU-integrated constrained soft actor-critic learning enabled fully distributed scheduling strategy for residential virtual power plant

In this study,a novel residential virtual power plant(RVPP)scheduling method that leverages a gate recurrent unit(GRU)-integrated deep reinforcement learning(DRL)algorithm is proposed.In the proposed scheme,the GRU-integrated DRL algorithm guides the RVPP to participate effectively in both the day-ahead and real-time markets,lowering the electricity purchase costs and consumption risks for end-users.The Lagrangian relaxation technique is introduced to transform the constrained Markov decision process(CMDP)into an unconstrained optimization problem,which guarantees that the constraints are strictly satisfied without determining the penalty coefficients.Furthermore,to enhance the scalability of the constrained soft actor-critic(CSAC)-based RVPP scheduling approach,a fully distributed scheduling architecture was designed to enable plug-and-play in the residential distributed energy resources(RDER).Case studies performed on the constructed RVPP scenario validated the performance of the proposed methodology in enhancing the responsiveness of the RDER to power tariffs,balancing the supply and demand of the power grid,and ensuring customer comfort.

Waist subcutaneous soft tissue metastasis of rectal mucinous adenocarcinoma: A case report

BACKGROUND Rectal mucinous adenocarcinoma(MAC)is a rare pathological type of rectal can-cer with unique pathological features and a poor prognosis.It is difficult to diag-nose and treat early because of the lack of specific manifestations in some aspects of the disease.The common metastatic organs of rectal cancer are the liver and lung;however,rectal carcinoma with metastasis to subcutaneous soft tissue is a rare finding.CASE SUMMARY In this report,the clinical data,diagnosis and treatment process,and postope-rative pathological features of a patient with left waist subcutaneous soft tissue masses were retrospectively analyzed.The patient underwent surgical treatment after admission and recovered well after surgery.The final pathological diagnosis was rectal MAC with left waist subcutaneous soft tissue metastasis.CONCLUSION Subcutaneous soft tissue metastasis of rectal MAC is rare,and it can suggest that the tumor is disseminated,and it can appear even earlier than the primary ma-lignant tumor,which is occult and leads to a missed diagnosis and misdiagnosis clinically.When a subcutaneous soft tissue mass of unknown origin appears in a patient with rectal cancer,a ma-lignant tumor should be considered.

The role of polyurethane foam compressible layer in the mechanical behaviour of multi-layer yielding supports for deep soft rock tunnels

The polyurethane foam(PU)compressible layer is a viable solution to the problem of damage to the secondary lining in squeezing tunnels.Nevertheless,the mechanical behaviour of the multi-layer yielding supports has not been thoroughly investigated.To fill this gap,large-scale model tests were conducted in this study.The synergistic load-bearing mechanics were analyzed using the convergenceconfinement method.Two types of multi-layer yielding supports with different thicknesses(2.5 cm,3.75 cm and 5 cm)of PU compressible layers were investigated respectively.Digital image correlation(DIC)analysis and acoustic emission(AE)techniques were used for detecting the deformation fields and damage evolution of the multi-layer yielding supports in real-time.Results indicated that the loaddisplacement relationship of the multi-layer yielding supports could be divided into the crack initiation,crack propagation,strain-hardening,and failure stages.Compared with those of the stiff support,the toughness,deformability and ultimate load of the yielding supports were increased by an average of 225%,61%and 32%,respectively.Additionally,the PU compressible layer is positioned between two primary linings to allow the yielding support to have greater mechanical properties.The analysis of the synergistic bearing effect suggested that the thickness of PU compressible layer and its location significantly affect the mechanical properties of the yielding supports.The use of yielding supports with a compressible layer positioned between the primary and secondary linings is recommended to mitigate the effects of high geo-stress in squeezing tunnels.

Experimental Study on Clogging Characteristics of Silt Soft Soil in Nansha District of Guangzhou

The silt soft soil in Nansha District of Guangzhou was the softest soft soil in China. It had the characteristics of high natural water content, high compressibility, long consolidation time, and complex layered distribution of soil layers. These characteristics formed the clogging characteristics of silt soft soil, which greatly increased the construction difficulty and hindered the construction progress. Therefore, based on the basic physical and mechanical properties of silt soft soil in Nansha District of Guangzhou, this paper evaluated the clogging characteristics of three silt soft soil areas in Nansha District of Guangzhou through long-term permeability test, and carried out scanning electron microscope test to explore the influence of different parameters and microstructure on the clogging difficulty of silt soft soil. The results showed that the silt soft soil Zone I and Zone II (shallow layer) in Nansha District of Guangzhou were divided into slight siltation levels, and the silt soft soil Zone III (deep layer) was mild siltation level. Large pores were widely distributed in shallow silt soft soil, while the continuity of large pores in deep silt soft soil was poor. The migration of fine particles that failed to establish contact with surrounding particles in the soil blocks the small pores of seepage and thus produces siltation.

Chronic Pain Management after Necrotizing Soft Tissue Infection (NSTI): A Case Report

Background: Necrotizing soft tissue infections (NSTIs) are potentially life threatening medical emergencies associated with devastating and rapidly spreading destruction of soft tissues. Atypical presentations and delayed early diagnosis can be significant challenges in managing NSTIs. The infectious process can start at any part of the body with rapid progression leading to limb amputation and high mortality rate. We present a case of a patient with NSTI, the sequelae and management of the chronic pain that developed. Aim: This case report looks to shed light on the importance of a plan for management of subacute and chronic pain in treating patients who present with Necrotizing soft tissue infection. Case presentation: A 53-year-old female who presented with septicemia and was subsequently admitted and treated for NSTI in 2014 resulting in amputation of her distal foot, toe digits, and now with ongoing chronic wound of the lower extremities along with chronic pain. Conclusion: Chronic pain as part of the sequelae of Necrotizing soft tissue infections needs to be anticipated by the health care management team in order to optimize patient care post operatively.