Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment.

BACKGROUND: Surgery is an important part of the management of oral cavity cancer with regard to both the removal of the primary tumour and removal of lymph nodes in the neck. Surgery is less frequently used in oropharyngeal cancer. Surgery alone may be treatment for early stage disease or surgery may be used in combination with radiotherapy, chemotherapy and immunotherapy/biotherapy. There is variation in the recommended timing and extent of surgery in the overall treatment regimens of people with these cancers. OBJECTIVES: To determine which surgical treatment modalities for oral cavity and oropharyngeal cancers result in increased overall survival, disease free survival, progression free survival and reduced recurrence. SEARCH STRATEGY: The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 17 February 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE via OVID (1950 to 17 February 2011) and EMBASE via OVID (1980 to 17 February 2011). There were no restrictions regarding language or date of publication. SELECTION CRITERIA: Randomised controlled trials where more than 50% of participants had primary tumours of the oral cavity or oropharynx, and which compared two or more surgical treatment modalities or surgery versus other treatment modalities. DATA COLLECTION AND ANALYSIS: Data extraction and assessment of risk of bias was undertaken independently by two or more review authors. Study authors were contacted for additional information as required. Adverse events data were collected from published trials. MAIN RESULTS: Seven trials (n = 669; 667 with cancers of the oral cavity) satisfied the inclusion criteria, but none were assessed as low risk of bias. Trials were grouped into three main comparisons. Four trials compared elective neck dissection (ND) with therapeutic neck dissection in patients with oral cavity cancer and clinically negative neck nodes, but differences in type of surgery and duration of follow-up made meta-analysis inappropriate. Three of these trials reported overall and disease free survival. One trial showed a benefit for elective supraomohyoid neck dissection compared to therapeutic ND in overall and disease free survival. Two trials found no difference between elective radical ND and therapeutic ND for the outcomes of overall survival and disease free survival. All four trials found reduced locoregional recurrence following elective ND.A further two trials compared elective radical ND with elective selective ND and found no difference in overall survival, disease free survival or recurrence. The final trial compared surgery plus radiotherapy to radiotherapy alone but data were unreliable because the trial stopped early and there were multiple protocol violations.None of the trials reported quality of life as an outcome. Two trials, evaluating different comparisons reported adverse effects of treatment. AUTHORS' CONCLUSIONS: Seven included trials evaluated neck dissection surgery in patients with oral cavity cancers. The review found weak evidence that elective neck dissection of clinically negative neck nodes at the time of removal of the primary tumour results in reduced locoregional recurrence, but there is insufficient evidence to conclude that elective neck dissection increases overall survival or disease free survival compared to therapeutic neck dissection. There is very weak evidence from one trial that elective supraomohyoid neck dissection may be associated with increased overall and disease free survival. There is no evidence that radical neck dissection increases overall survival compared to conservative neck dissection surgery. Reporting of adverse events in all trials was poor and it was not possible to compare the quality of life of patients undergoing different surgeries

From Operator Algebras to Superconformal Field Theory

We make a review on the recent progress in the operator algebraic approach to (super)conformal field theory. We discuss representation theory, classification results, full and boundary conformal field theories, relations to supervertex operator algebras and Moonshine, connections to subfactor theory and noncommutative geometry

Discretization Errors and Rotational Symmetry: The Laplacian Operator on Non-Hypercubical Lattices

Discretizations of the Laplacian operator on non-hypercubical lattices are discussed in a systematic approach. It is shown that order $a^2$ errors always exist for discretizations involving only nearest neighbors. Among all lattices with the same density of lattice sites, the hypercubical lattices always have errors smaller than other lattices with the same number of spacetime dimensions. On the other hand, the four dimensional checkerboard lattice (also known as the Celmaster lattice) is the only lattice which is isotropic at order $a^2$. Explicit forms of the discretized Laplacian operators on root lattices are presented, and different ways of eliminating order $a^2$ errors are discussed.Comment: 30 pages in REVTe

Automatic misclassification rejection for LDA classifier using ROC curves

This paper presents a technique to improve the performance of an LDA classifier by determining if the predicted classification output is a misclassification and thereby rejecting it. This is achieved by automatically computing a class specific threshold with the help of ROC curves. If the posterior probability of a prediction is below the threshold, the classification result is discarded. This method of minimizing false positives is beneficial in the control of electromyography (EMG ) based upper-limb prosthetic devices. It is hypothesized that a unique EMG pattern is associated with a specific hand gesture. In reality, however, EMG signals are difficult to distinguish, particularly in the case of multiple finger motions, and hence classifiers are trained to recognize a set of individual gestures. However, it is imperative that misclassifications be avoided because they result in unwanted prosthetic arm motions which are detrimental to device controllability. This warrants the need for the proposed technique wherein a misclassified gesture prediction is rejected resulting in no motion of the prosthetic arm. The technique was tested using surface EMG data recorded from thirteen amputees performing seven hand gestures. Results show the number of misclassifications was effectively reduced, particularly in cases with low original classification accuracy

Study on interaction between temporal and spatial information in classification of EMG signals in myoelectric prostheses

Advanced forearm prosthetic devices employ classifiers to recognize different electromyography (EMG) signal patterns, in order to identify the user's intended motion gesture. The classification accuracy is one of the main determinants of real-time controllability of a prosthetic limb and hence the necessity to achieve as high an accuracy as possible. In this paper, we study the effects of the temporal and spatial information provided to the classifier on its offline performance and analyze their interdependencies. EMG data associated with seven practical hand gestures were recorded from partial-hand and trans-radial amputee volunteers as well as able-bodied volunteers. An extensive investigation was conducted to study the effect of analysis window length, window overlap a nd the number of electrode channels on the classification accuracy as well as their interactions. Our main discoveries are that the effect of analysis window length on classification accuracy is practically independent of the number of electrodes for all participant groups; window overlap has no direct influence on classifier performance, irrespective of the window length, number of channels or limb condition; the type of limb deficiency and the existing channel count influence the reduction in classification error achieved by adding more number of channels; partial-hand amputees outperform trans-radial amputees, with classification accuracies of only 11.3 % below values achieved by able-bodied volunteers

Precursor-derived in-water peracetic acid impacts on broiler performance, gut microbiota and antimicrobial resistance genes

Past antimicrobial misuse has led to the spread of antimicrobial resistance amongst pathogens, reportedly a major public health threat. Attempts to reduce the spread of antimicrobial resistant (AMR) bacteria are in place worldwide, among which finding alternatives to antimicrobials have a pivotal role. Such molecules could be used as “green alternatives” to reduce the bacterial load either by targeting specific bacterial groups or more generically, functioning as biocides when delivered in vivo. In this study, the effect of in-water peracetic acid as a broad-spectrum antibiotic alternative for broilers was assessed via hydrolysis of precursors sodium percarbonate and tetraacetylethylenediamine. Six equidistant peracetic acid levels were tested from 0 to 50 ppm using four pens per treatment and 4 birds per pen (i.e., 16 birds per treatment and 96 in total). Peracetic acid was administered daily from d 7 to 14 of age whilst measuring performance parameters and end-point bacterial concentration (qPCR) in crop, jejunum, and ceca, as well as crop 16S sequencing. PAA treatment, especially at 20, 30, and 40 ppm, increased body weight at d 14, and feed intake during PAA exposure compared to control (P < 0.05). PAA decreased bacterial concentration in the crop only (P < 0.05), which was correlated to better performance (P < 0.05). Although no differences in alpha- and beta-diversity were found, it was observed a reduction of Lactobacillus (P < 0.05) and Flectobacillus (P < 0.05) in most treatments compared to control, together with an increased abundance of predicted 4-aminobutanoate degradation (V) pathway. The analysis of the AMR genes did not point towards any systematic differences in gene abundance due to treatment administration. This, together with the rest of our observations could indicate that proximal gut microbiota modulation could result in performance amelioration. Thus, peracetic acid may be a valid antimicrobial alternative that could also positively affect performance

Stress transmission in granular matter

The transmission of forces through a disordered granular system is studied by means of a geometrical-topological approach that reduces the granular packing into a set of layers. This layered structure constitutes the skeleton through which the force chains set up. Given the granular packing, and the region where the force is applied, such a skeleton is uniquely defined. Within this framework, we write an equation for the transmission of the vertical forces that can be solved recursively layer by layer. We find that a special class of analytical solutions for this equation are L\'evi-stable distributions. We discuss the link between criticality and fragility and we show how the disordered packing naturally induces the formation of force-chains and arches. We point out that critical regimes, with power law distributions, are associated with the roughness of the topological layers. Whereas, fragility is associated with local changes in the force network induced by local granular rearrangements or by changes in the applied force. The results are compared with recent experimental observations in particulate matter and with computer simulations.Comment: 14 pages, Latex, 5 EPS figure

The chromatic polynomial of fatgraphs and its categorification

Motivated by Khovanov homology and relations between the Jones polynomial and graph polynomials, we construct a homology theory for embedded graphs from which the chromatic polynomial can be recovered as the Euler characteristic. For plane graphs, we show that our chromatic homology can be recovered from the Khovanov homology of an associated link. We apply this connection with Khovanov homology to show that the torsion-free part of our chromatic homology is independent of the choice of planar embedding of a graph. We extend our construction and categorify the Bollobas-Riordan polynomial (a generalisation of the Tutte polynomial to embedded graphs). We prove that both our chromatic homology and the Khovanov homology of an associated link can be recovered from this categorification.Comment: A substantial revision. To appear in Advances in Mathematic

Local conformal nets arising from framed vertex operator algebras

We apply an idea of framed vertex operator algebras to a construction of local conformal nets of (injective type III_1) factors on the circle corresponding to various lattice vertex operator algebras and their twisted orbifolds. In particular, we give a local conformal net corresponding to the moonshine vertex operator algebras of Frenkel-Lepowsky-Meurman. Its central charge is 24, it has a trivial representation theory in the sense that the vacuum sector is the only irreducible DHR sector, its vacuum character is the modular invariant J-function and its automorphism group (the gauge group) is the Monster group. We use our previous tools such as alpha-induction and complete rationality to study extensions of local conformal nets.Comment: 24 pages; The automorphism group of the moonshine net is now identified with the monster grou

Identification of policies for a sustainable legal trade in rhinoceros horn based on population projection and socioeconomic models

Between 1990 and 2007, 15 southern white (Ceratotherium simum simum) and black (Diceros bicornis) rhinoceroses on average were killed illegally every year in South Africa. Since 2007 illegal killing of southern white rhinoceros for their horn has escalated to >950 individuals/year in 2013. We conducted an ecological-economic analysis to determine whether a legal trade in southern white rhinoceros horn could facilitate rhinoceros protection. Generalized linear models were used to examine the socioeconomic drivers of poaching, based on data collected from 1990 to 2013, and to project the total number of rhinoceroses likely to be illegally killed from 2014 to 2023. Rhinoceros population dynamics were then modeled under 8 different policy scenarios that could be implemented to control poaching. We also estimated the economic costs and benefits of each scenario under enhanced enforcement only and a legal trade in rhinoceros horn and used a decision support framework to rank the scenarios with the objective of maintaining the rhinoceros population above its current size while generating profit for local stakeholders. The southern white rhinoceros population was predicted to go extinct in the wild <20 years under present management. The optimal scenario to maintain the rhinoceros population above its current size was to provide a medium increase in antipoaching effort and to increase the monetary fine on conviction. Without legalizing the trade, implementing such a scenario would require covering costs equal to approximately $147,000,000/year. With a legal trade in rhinoceros horn, the conservation enterprise could potentially make a profit of$717,000,000/year. We believe the 35-year-old ban on rhinoceros horn products should not be lifted unless the money generated from trade is reinvested in improved protection of the rhinoceros population. Because current protection efforts seem to be failing, it is time to evaluate, discuss, and test alternatives to the present policy.Peer reviewe