Characteristics of maxillofacial injuries resulting from road traffic accidents – a 5 year review of the case records from Department of Maxillofacial Surgery in Katowice, Poland

BACKGROUND: In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland) from January 2001 to December 2005. METHODS: The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident). RESULTS: The traffic accidents were the cause of 19,93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22,21%), followed by tooth and alveolar process injuries (20,71%) and mandibular fractures (18,69%). All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM. CONCLUSION: Our results exhibit that road traffic accidents remain among the main reasons of maxillofacial injuries following the traumas resulting from assaults and interpersonal violence. This succession of etiologic factors is in accordance with the data from the most developed countries. The relatively high incidence of injuries resulting from traffic accidents indicates the necessity to reinforce legislation aimed to prevent road traffic crashes and thus to reduce maxillofacial injuries among children and adults

Nationwide randomised trial evaluating elective neck dissection for early stage oral cancer (SEND study) with meta-analysis and concurrent real-world cohort

BACKGROUND: Guidelines remain unclear over whether patients with early stage oral cancer without overt neck disease benefit from upfront elective neck dissection (END), particularly those with the smallest tumours. // METHODS: We conducted a randomised trial of patients with stage T1/T2 N0 disease, who had their mouth tumour resected either with or without END. Data were also collected from a concurrent cohort of patients who had their preferred surgery. Endpoints included overall survival (OS) and disease-free survival (DFS). We conducted a meta-analysis of all six randomised trials. // RESULTS: Two hundred fifty randomised and 346 observational cohort patients were studied (27 hospitals). Occult neck disease was found in 19.1% (T1) and 34.7% (T2) patients respectively. Five-year intention-to-treat hazard ratios (HR) were: OS HR = 0.71 (p = 0.18), and DFS HR = 0.66 (p = 0.04). Corresponding per-protocol results were: OS HR = 0.59 (p = 0.054), and DFS HR = 0.56 (p = 0.007). END was effective for small tumours. END patients experienced more facial/neck nerve damage; QoL was largely unaffected. The observational cohort supported the randomised findings. The meta-analysis produced HR OS 0.64 and DFS 0.54 (p < 0.001). // CONCLUSION: SEND and the cumulative evidence show that within a generalisable setting oral cancer patients who have an upfront END have a lower risk of death/recurrence, even with small tumours. // CLINICAL TRIAL REGISTRATION: NIHR UK Clinical Research Network database ID number: UKCRN 2069 (registered on 17/02/2006), ISCRTN number: 65018995, ClinicalTrials.gov Identifier: NCT00571883

Rate-invariant analysis of covariance trajectories

Statistical analysis of dynamic systems, such as videos and dynamic functional connectivity, is often translated into a problem of analyzing trajectories of relevant features, particularly covariance matrices. As an example, in video-based action recognition, a natural mathematical representation of activity videos is as parameterized trajectories on the set of symmetric, positive-definite matrices (SPDMs). The variable execution-rates of actions, implying arbitrary parameterizations of trajectories, complicates their analysis and classification. To handle this challenge, we represent covariance trajectories using transported square-root vector fields (TSRVFs), constructed by parallel translating scaled-velocity vectors of trajectories to their starting points. The space of such representations forms a vector bundle on the SPDM manifold. Using a natural Riemannian metric on this vector bundle, we approximate geodesic paths and geodesic distances between trajectories in the quotient space of this vector bundle. This metric is invariant to the action of the reparameterization group, and leads to a rate-invariant analysis of trajectories. In the process, we remove the parameterization variability and temporally register trajectories during analysis. We demonstrate this framework in multiple contexts, using both generative statistical models and discriminative data analysis. The latter is illustrated using several applications involving video-based action recognition and dynamic functional connectivity analysis

Identifying Fishes through DNA Barcodes and Microarrays

Background: International fish trade reached an import value of 62.8 billion Euro in 2006, of which 44.6% are covered by the European Union. Species identification is a key problem throughout the life cycle of fishes: from eggs and larvae to adults in fisheries research and control, as well as processed fish products in consumer protection. Methodology/Principal Findings: This study aims to evaluate the applicability of the three mitochondrial genes 16S rRNA (16S), cytochrome b (cyt b), and cytochrome oxidase subunit I (COI) for the identification of 50 European marine fish species by combining techniques of ‘‘DNA barcoding’’ and microarrays. In a DNA barcoding approach, neighbour Joining (NJ) phylogenetic trees of 369 16S, 212 cyt b, and 447 COI sequences indicated that cyt b and COI are suitable for unambiguous identification, whereas 16S failed to discriminate closely related flatfish and gurnard species. In course of probe design for DNA microarray development, each of the markers yielded a high number of potentially species-specific probes in silico, although many of them were rejected based on microarray hybridisation experiments. None of the markers provided probes to discriminate the sibling flatfish and gurnard species. However, since 16S-probes were less negatively influenced by the ‘‘position of label’’ effect and showed the lowest rejection rate and the highest mean signal intensity, 16S is more suitable for DNA microarray probe design than cty b and COI. The large portion of rejected COI-probes after hybridisation experiments (.90%) renders the DNA barcoding marker as rather unsuitable for this high-throughput technology. Conclusions/Significance: Based on these data, a DNA microarray containing 64 functional oligonucleotide probes for the identification of 30 out of the 50 fish species investigated was developed. It represents the next step towards an automated and easy-to-handle method to identify fish, ichthyoplankton, and fish products

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Cancer Biomarker Discovery: The Entropic Hallmark

Background: It is a commonly accepted belief that cancer cells modify their transcriptional state during the progression of the disease. We propose that the progression of cancer cells towards malignant phenotypes can be efficiently tracked using high-throughput technologies that follow the gradual changes observed in the gene expression profiles by employing Shannon's mathematical theory of communication. Methods based on Information Theory can then quantify the divergence of cancer cells' transcriptional profiles from those of normally appearing cells of the originating tissues. The relevance of the proposed methods can be evaluated using microarray datasets available in the public domain but the method is in principle applicable to other high-throughput methods. Methodology/Principal Findings: Using melanoma and prostate cancer datasets we illustrate how it is possible to employ Shannon Entropy and the Jensen-Shannon divergence to trace the transcriptional changes progression of the disease. We establish how the variations of these two measures correlate with established biomarkers of cancer progression. The Information Theory measures allow us to identify novel biomarkers for both progressive and relatively more sudden transcriptional changes leading to malignant phenotypes. At the same time, the methodology was able to validate a large number of genes and processes that seem to be implicated in the progression of melanoma and prostate cancer. Conclusions/Significance: We thus present a quantitative guiding rule, a new unifying hallmark of cancer: the cancer cell's transcriptome changes lead to measurable observed transitions of Normalized Shannon Entropy values (as measured by high-throughput technologies). At the same time, tumor cells increment their divergence from the normal tissue profile increasing their disorder via creation of states that we might not directly measure. This unifying hallmark allows, via the the Jensen-Shannon divergence, to identify the arrow of time of the processes from the gene expression profiles, and helps to map the phenotypical and molecular hallmarks of specific cancer subtypes. The deep mathematical basis of the approach allows us to suggest that this principle is, hopefully, of general applicability for other diseases

To treat...or not to treat? Clinicians' views on the management of oral potentially malignant disorders.

Oral potentially malignant disorders (PMD) are recognisable mucosal conditions that have a variable and unpredictable risk of transformation to invasive squamous cell carcinoma (SCC). Modern management relies initially on clinical recognition of suspicious lesions and histopathological assessment and grading after incisional biopsy. However, it then varies from wide excision to observation and review, and depends not only on the severity of dysplasia but also on the clinician's preference as there is no high-level evidence to support best practice. We invited clinicians from oral and maxillofacial surgery, oral medicine, ear, nose, and throat (ENT), and plastic surgery, to complete an online questionnaire on current practice, which included 3 fictitious cases, to ascertain their views on the management of PMD and to find out whether they would be interested in becoming involved in a proposed future randomised controlled trial (RCT). Of the 251 who replied, 178 (71%) were oral and maxillofacial surgeons, and 99 (39%) expressed an interest in participating in a future RCT. Most respondents (n=164 or 99%) would always treat severely dysplastic lesions by excision or laser ablation, whereas only 8% (n=13) would always excise mild dysplasia. The greatest equipoise among those interested in taking part in a RCT was found in the case of moderate dysplasia for which 27% (n=27) favoured observation compared with surgical excision or laser ablation. This study shows that there is support for a multicentre, prospective RCT that compares observation with resection and laser ablation in patients with moderate dysplasia