ELSA

• Innovative coupling between T-LCA, crop modeling and experimental design • The environmental performance of scenarios is assessed in a climate change context • This framework allows exploring various scenarios and services of cultivated area • Irrigation increase and stabilize the environmental performance of irrigated areas • This paper promotes coupling complex models with T-LCA and experimental design

ImportanceThe retrograde cricopharyngeus dysfunction (R-CPD) is an emerging topic in otolaryngology, gastroenterology, and primary care.ObjectiveTo review the current literature about the etiology, clinical presentation, and management of retrograde cricopharyngeus dysfunction (R-CPD).DesignSystematic review.SettingThree investigators conducted the PubMED, Scopus, and Cochrane Library review of the literature related to the etiologies and management of patients with R-CPD through the PRISMA statements.ParticipantsStudies that incorporated R-CPD patients.InterventionsIn-office, or operating room botulinum toxin injection, or no treatment.Main outcome measuresEtiology, clinical presentation, and therapeutic outcomes.ResultsSeventeen studies met the inclusion criteria (826 patients). A family history was reported in 28.0% of cases with most patients developing R-CDP symptoms in childhood (55.5%). In addition to the cardinal symptom of the inability to belch, associated complaints of bloating and chest pain, gurgling noises, and excessive flatulence were found in 95.7%, 86%, and 80.2% of cases, respectively.The diagnosis was recognized by patients themselves in 78.9% of cases. The immediate success rate of botulinum toxin injection into the cricopharyngeal sphincter in facilitating burping was 92.5%. Recurrence occurred in the first month of follow-up in 9.5% of cases, whereas 12.6% and 27.9% of patients had recurrence during the 1–5 months and more than 6 months posttreatment, respectively. Transient dysphagia is the most prevalent complication after botulinum toxin injection (31.1%). The heterogeneity was high across studies, limiting the establishment of further combined analyses.Conclusion and relevanceR-CPD is a recently-recognized and likely-underdiagnosed condition associated with severe symptoms affecting the quality of life of patients. Future studies are needed to elucidate the etiology of this condition, develop adequate patient-reported outcome questionnaires for the baseline and follow-up evaluations of symptoms, and propose therapeutic consensus.

Social cognition enables the processing of information necessary to evolve within a social group. Neuropsychology explores models linking brain networks to social information processing. Social cognition is closely tied to the concept of Emotional Intelligence (EI), defined as the mental ability involved in accurately perceiving, understanding, using, and regulating one’s own emotions and those of others. EI could explain the variability of socially guided behavior. Therefore, EI seems to be an interesting concept for neuropsychologists. EI abilities are summarized, showing the neuroanatomical correlates, the tools enabling their assessment, and the functional impact in everyday life. Perceiving emotions in others, alexithymia, empathy, emotional memory, decision-making, theory of mind, and mind regulation are neuropsychological processes than can be explained through the lens of the concept of Emotional Intelligence. Creating standardized tools to assess perception, identification, emotional regulation skills, establishing emotional intelligence profiles, and comparing them to rational intelligence should contribute to enhancing our comprehension of social interactions and their associated dysfunctions.

The aim was to estimate the effect of drug-induced sleep endoscopy (DISE) on surgical outcomes after soft tissue surgery for obstructive sleep apnea (OSA). Systematic review and meta-analysis. Adult patients with OSA and candidates for soft tissue surgery, with and without preoperative DISE, were included. A systematic literature search of Medline, Web of Science, and Cochrane databases was performed from inception to December 31, 2021. Studies directly comparing patients with and without preoperative DISE were included. Success rate, change in apnea-hypopnea index (AHI), change in minimum SpO2 and change in Epworth Sleepiness Scale (ESS) score were extracted. Random-effect models were used to pool estimates. Seven out of 619 articles were included, representing 791 patients (389 in the DISE group and 402 in the no DISE group). DISE was neither associated with a higher success rate (pooled OR 1.34, 95% CI 0.69-2.59, p=0.39) after soft tissue surgery for OSA, nor a significant change in AHI (-4.69 events/hour, 95% CI -11.10 to 1.72, p=0.15), minimal SpO2 (mean increase of 2.02%, 95% CI -0.26 to 4.29, p=0.08) and ESS (mean difference of 1.29, 95% CI -0.48 to 3.05, p=0.15) when compared to patients without preoperative DISE. Soft tissue surgery does not give better results after DISE compared to when DISE is not performed. However, given the overall low level of evidence of included studies, future well-conducted studies should confirm or overturn these results and clarify the added value of DISE.

Abstract PurposeThe aim of the present study was to estimate the prevalence and the recovery rate of self-reported chemosensory dysfunction 6-month after SARS-CoV-2 infection acquired during the predominance of the Omicron BA.1 subvariant.MethodsProspective study based on the sino-nasal outcome tool 22 (SNOT-22), item "sense of smell or taste" and additional outcomes. Results. Of 338 patients with mild-to-moderate COVID-19 completing the baseline survey, 294 (87.0%) responded to the 6-month follow-up interview. Among them, 101 (34.4 %) and 4 (1.4 %) reported an altered sense of smell or taste at baseline and at 6 months, respectively. Among the 101 patients with COVID-19-associated smell or taste dysfunction during the acute phase of the disease, 97 (96.0%) reported complete resolution at 6 months. The duration of smell or taste impairment was significantly shorter in vaccinated patients (p=0.007).ConclusionsCompared with that observed in subjects infected during the first wave of the pandemic, the recovery rate from chemosensory dysfunctions reported in the present series of patients infected during the predominance of the Omicron BA.1 subvariant was more favourable with a shorter duration being positively influenced by vaccination.

To investigate the clinical patterns and disease evolution of laryngopharyngeal reflux (LPR) patients. Patients with LPR diagnosed by hypopharyngeal-esophageal impedance-pH monitoring were prospectively followed in three medical centers. Symptoms and findings were assessed with reflux symptom score (RSS) and reflux sign assessment (RSA). Patients were treated with 3-to 9-month diet and combination of proton pump inhibitors, alginate or magaldrate. Patients were followed for 3 years to determine the clinical evolution of symptoms over time. LPR that did not recur was defined as acute. Recurrent LPR consisted of reflux with one or several recurrences yearly despite successful treatment. Chronic LPR was reflux with a chronic course of symptoms. Predictive indicators of clinical evolution were investigated. One hundred forty patients and 82 healthy individuals completed the evaluations. Among patients, 41 (29.3%), 57 (40.7%), and 42 (30.0%) had acute, recurrent, or chronic LPR respectively. Baseline quality of life-RSS (QoL-RSS) and RSS total scores were significantly higher in chronic LPR patients. The post-treatment decrease of QoL-RSS and RSS of acute LPR patients were significantly faster as compared to recurrent and chronic patients. QoL-RSS >5 reported adequate sensitivity (94.2) and specificity (75.3). QoL-RSS thresholds defined acute (QoL-RSS=6-25), recurrent (QoL-RSS=26-38), and chronic (QoL-RSS > 38) LPR. Baseline QoL-RSS may predict the clinical course of LPR patients: acute, recurrent, or chronic. A novel classification system that groups patients according to the longevity, severity, and therapeutic response of symptoms was proposed: the International Federation of Otorhinolaryngological Societies Classification of LPR. 3 Laryngoscope, 133:1073-1080, 2023.