•In laryngeal oncology it is crucial to assess mobility of vocal cord-arytenoid unit.•Current mobility assessment is flawed by weak inter-observer agreement.•Tumor extension assessment by dedicated ...radiologists is recommended.
In clinical practice the assessment of the “vocal cord-arytenoid unit” (VCAU) mobility is crucial in the staging, prognosis, and choice of treatment of laryngeal squamous cell carcinoma (LSCC). The aim of the present study was to measure repeatability and reliability of clinical assessment of VCAU mobility and radiologic analysis of posterior laryngeal extension.
In this multi-institutional retrospective study, patients with LSCC-induced impairment of VCAU mobility who received curative treatment were included; pre-treatment endoscopy and contrast-enhanced imaging were collected and evaluated by raters. According to their evaluations, concordance, number of assigned categories, and inter- and intra-rater agreement were calculated.
Twenty-two otorhinolaryngologists evaluated 366 videolaryngoscopies (total evaluations: 2170) and 6 radiologists evaluated 237 imaging studies (total evaluations: 477). The concordance of clinical rating was excellent in only 22.7% of cases. Overall, inter- and intra-rater agreement was weak. Supraglottic cancers and transoral endoscopy were associated with the lowest inter-observer reliability values. Radiologic inter-rater agreement was low and did not vary with imaging technique. Intra-rater reliability of radiologic evaluation was optimal.
The current methods to assess VCAU mobility and posterior extension of LSCC are flawed by weak inter-observer agreement and reliability. Radiologic evaluation was characterized by very high intra-rater agreement, but weak inter-observer reliability. The relevance of VCAU mobility assessment in laryngeal oncology should be re-weighted. Patients affected by LSCC requiring imaging should be referred to dedicated radiologists with experience in head and neck oncology.
Treatment of inverted papilloma of the maxillary sinus (IPMS) has a lower success rate compared to other IPs. As such, its correct management generally needs trans-nasal endoscopic medial ...maxillectomy (EMMs) for adequate resection. The aim of this manuscript is to describe outcomes and major prognostic factors of a cohort of patients with IPMS who were treated with EMM.
In this multicentric study, patients affected with IPMS and treated with EMMs were included. The site of origin of the IPMS were studied as well as the type of EMM performed. The histological features (IP vs dysplasia), type of mucosal resection (total vs. pedicle oriented), and post-operative complications were analyzed.
310 patients were included (212 primary and 98 recurrent cases). After a mean follow-up of 45.4 months, 15 patients experienced recurrence (4.8%) due to the application of EMMs tailored to the surgical insertion point. Dysplasia was significantly associated with a higher risk of recurrence. The rates of early and late complications were 11.6% and 11.9%, respectively.
IPMS resection via tailored EMM is associated with excellent disease control, thus excluding the systematic use of extended EMMs, which can however be justified in case of dysplastic IPMS given its significant impact on recurrence.
Using a longitudinal dataset linking biometric and survey data from several cohorts of young adults before and during the COVID-19 pandemic (Formula: see text), we document large disruptions to ...physical activity, sleep, time use, and mental health. At the onset of the pandemic, average steps decline from 10,000 to 4,600 steps per day, sleep increases by 25 to 30 min per night, time spent socializing declines by over half to less than 30 min, and screen time more than doubles to over 5 h per day. Over the course of the pandemic from March to July 2020 the proportion of participants at risk for clinical depression ranges from 46% to 61%, up to a 90% increase in depression rates compared to the same population just prior to the pandemic. Our analyses suggest that disruption to physical activity is a leading risk factor for depression during the pandemic. However, restoration of those habits through a short-term intervention does not meaningfully improve mental well-being.
In previous work, Giuntella et al. (Proc Natl Acad Sci 118:e2016632118, 2021), we documented large disruptions to physical activity, sleep, time use and mental health among young adults at the onset ...of the COVID-19 pandemic in Spring 2020. This study explores the trends 1 year into COVID-19, as vaccines began to roll out, COVID-19 deaths declined, and social distancing measures eased in the United States. We combine biometric and survey data from multiple cohorts of college students spanning Spring 2019 through Spring 2021 (N = 1179). Our results show persistent impacts of the pandemic on physical activity and mental health. One year into the pandemic, daily steps averaged about 6300 per day compared to about 9800 per day prior to the pandemic, a 35% decline. Almost half of participants were at risk of clinical depression compared to a little over one-third prior to the pandemic, a 36% increase. The impacts on screen time, social interactions and sleep duration at the onset of COVID-19 largely dissipated over the course of the pandemic, though screen time remained significantly higher than pre-pandemic levels. In contrast to the sharp changes in lifestyle and mental health documented as the pandemic emerged in March 2020, we do not find evidence of behavioral changes or improvements in mental well-being over the course of Spring 2021 as the pandemic eased.
Migliaia di reperti ceramici sono emersi da indagini archeologiche tra gli anni '80 del XX secolo e il 2014 a Venezia e Mestre, nella vicina terraferma: nell’ex-convento dei Frari a San Polo, ...pregevoli graffite del primo Rinascimento e una maiolica a lustro, usate come riempimento del soffitto a volte di un salone; a S. Pietro di Castello, S. Giobbe a Cannaregio e S. Maria delle Grazie a Mestre immondezzai hanno restituito invetriate monocrome o dipinte su ingobbio, graffite, maiolica berettina. Ben attestate le maioliche dalla Romagna, specie “berettina” e "stile compendiario"; da S. Giobbe provengono anche un albarello in fritware, crogioli, pietra ollare e reperti vitrei.
We design a new procedure for measuring competitiveness and use it to estimate the magnitude of the gender gap in competitiveness. Before working on a task, participants choose what percentage of ...their payoffs will be based on a piece-rate compensation scheme; the rest of their payoff is allocated to a competitive compensation scheme. This novel procedure allows us to distinguish between 101 levels of competitiveness, as opposed to the binary measure used in the literature. Whereas the binary measure allows researchers to conclude that about twice as many men as women choose to compete (typically two-thirds versus one-third), the new procedure sheds light on the intensive margin. We find that the intensity of the preference is more extreme than the binary measure could detect. For example, we find that only one-fifth of the most competitive 25% of our participants are women, and the most competitive 10% of our participants are all men. The new procedure also allows us to study the correlation between competitiveness and parameters such as overconfidence, attitudes toward risk, and ambiguity.
Data and the online appendix are available at
https://doi.org/10.1287/mnsc.2016.2673
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This paper was accepted by Gérard Cachon, behavioral economics.
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