Advanced head and neck cancer: Long-term results of chemo-radiotherapy, complications and induction of second malignancies

Background: Chemo-radiotherapy is superior to radiotherapy alone in the treatment of advanced, inoperable head and neck cancer. The long-term treatment results, the induction of second malignant tumors, and other long-term toxicities are not well defined. Patients and Methods: 100 consecutive patients with advanced head and neck cancer who were treated at our center were studied. Treatment results, survival, the occurrence of late complications, and second malignant tumors (SMT) were investigated. 78 patients were treated with a protocol combining cisplatinum, 5-fluorouracil, folinic acid and hyper-fractionated irradiation. 22 patients were treated with other chemo-radiotherapy protocols. The relative risk of developing an SMT was compared with that within the normal population. Results: The cumulative total probability of survival was 51.1% at 2 years and 38.7% at 4 years. The probability of relapse-free survival was 39.9% at 2 years and 36.7% at 4 years. A total of 7 patients developed SMT (4 cases of lung cancer, 2 colon cancers, 1 skin cancer). After 6 years, a cumulative risk of SMT of 8.7% was observed. The relative risk of developing an SMT was significantly increased (4.45-fold in males) compared with a normal population. 13 of 38 evaluable patients (34.2%) had severe late complications like fibrosis of soft tissues, nerve lesions, or were dependent on tracheal cannulas. Conclusions: The treatment results and long-term prognoses in our population of unselected high-risk patients are unsatisfactory, but comparable to those from multicenter studies. About 35% of patients become long-term (> 4 years) survivors. SMT generally occur early, have a poor prognosis and, most likely, are not treatment-related. Approximately 30% of long-term survivors have severe, often incapacitating late effects. The treatment and - if possible - prevention of these late effects is important for the quality of life of patients who survived advanced head and neck cancer

Visual span and change detection in soccer: an expertise study

There is evidence to suggest that sports experts are able to extract more perceptual information from a single fixation than novices when exposed to meaningful tasks that are specific to their field of expertise. In particular, Reingold et al. (2001) showed that chess experts use a larger visual span including fewer fixations when compared to their less skilled counterparts. The aim of the present study was to examine whether also in a more complex environment, namely soccer, skilled players use a larger visual span and fewer fixations than less skilled players when attempting to recognise players' positions. To this end, we combined the gaze-contingent window technique with the change detection paradigm. Results seem to suggest that skilled soccer players do not use a larger visual span than less skilled players. However, skilled soccer players showed significantly fewer fixations of longer duration than their less skilled counterparts, supporting the notion that experts may extract more information from a single glance. © 2011 Psychology Press

Preoperative Exercise Training to Prevent Postoperative Pulmonary Complications in Adults Undergoing Major Surgery. A Systematic Review and Meta-analysis with Trial Sequential Analysis.

Rationale: Poor preoperative physical fitness and respiratory muscle weakness are associated with postoperative pulmonary complications (PPCs) that result in prolonged hospital length of stay and increased mortality.Objectives: To examine the effect of preoperative exercise training on the risk of PPCs across different surgical settings.Methods: We searched MEDLINE, Web of Science, Embase, the Physiotherapy Evidence Database, and the Cochrane Central Register, without language restrictions, for studies from inception to July 2020. We included randomized controlled trials that compared patients receiving exercise training with those receiving usual care or sham training before cardiac, lung, esophageal, or abdominal surgery. PPCs were the main outcome; secondary outcomes were preoperative functional changes and postoperative mortality, cardiovascular complications, and hospital length of stay. The study was registered with PROSPERO (International Prospective Register of Systematic Reviews).Results: From 29 studies, 2,070 patients were pooled for meta-analysis. Compared with the control condition, preoperative exercise training was associated with a lower incidence of PPCs (23 studies, 1,864 patients; relative risk, 0.52; 95% confidence interval [CI], 0.41 to 0.66; grading of evidence, moderate); Trial Sequential Analysis confirmed effectiveness, and there was no evidence of difference of effect across surgeries, type of training (respiratory muscles, endurance or combined), or preoperative duration of training. At the end of the preoperative period, exercise training resulted in increased peak oxygen uptake (weighted mean difference [WMD], +2 ml/kg/min; 99% CI, 0.3 to 3.7) and higher maximal inspiratory pressure (WMD, +12.2 cm H <sub>2</sub> O; 99% CI, 6.3 to 18.2). Hospital length of stay was shortened (WMD, -2.3 d; 99% CI, -3.82 to -0.75) in the intervention group, whereas no difference was found in postoperative mortality.Conclusions: Preoperative exercise training improves physical fitness and reduces the risk of developing PPCs while minimizing hospital resources use, regardless of the type of intervention and surgery performed.Systematic review registered with https://www.crd.york.ac.uk/prospero/ (CRD 42018096956)

A Feasability Study of Color Flow Doppler Vectorization for Automated Blood Flow Monitoring

An ongoing issue in vascular medicine is the measure of the blood flow. Catheterization remains the gold standard measurement method, although non-invasive techniques are an area of intense research. We hereby present a computational method for real-time measurement of the blood flow from color flow Doppler data, with a focus on simplicity and monitoring instead of diagnostics. We then analyze the performance of a proof-of-principle software implementation. We imagined a geometrical model geared towards blood flow computation from a color flow Doppler signal, and we developed a software implementation requiring only a standard diagnostic ultrasound device. Detection performance was evaluated by computing flow and its determinants (flow speed, vessel area, and ultrasound beam angle of incidence) on purposely designed synthetic and phantom-based arterial flow simulations. Flow was appropriately detected in all cases. Errors on synthetic images ranged from nonexistent to substantial depending on experimental conditions. Mean errors on measurements from our phantom flow simulation ranged from 1.2 to 40.2% for angle estimation, and from 3.2 to 25.3% for real-time flow estimation. This study is a proof of concept showing that accurate measurement can be done from automated color flow Doppler signal extraction, providing the industry the opportunity for further optimization using raw ultrasound data

Phonons and related properties of extended systems from density-functional perturbation theory

This article reviews the current status of lattice-dynamical calculations in crystals, using density-functional perturbation theory, with emphasis on the plane-wave pseudo-potential method. Several specialized topics are treated, including the implementation for metals, the calculation of the response to macroscopic electric fields and their relevance to long wave-length vibrations in polar materials, the response to strain deformations, and higher-order responses. The success of this methodology is demonstrated with a number of applications existing in the literature.Comment: 52 pages, 14 figures, submitted to Review of Modern Physic

The dynamics of Early Celtic consumption practices: a case study of the pottery from the Heuneburg

The Early Celtic site of the Heuneburg (Baden-Wuerttemberg, Germany) has long been understood as a hallmark of early urbanization in Central Europe. The rich collection of Mediterranean imports recovered from the settlement, the elite burials in its surroundings and the Mediterranean-inspired mudbrick fortification wall further point to the importance of intercultural connections with the Mediterranean as a crucial factor in the transformation of Early Iron Age societies. We describe a new facet of this process by studying the transformation of consumption practices, especially drinking habits, brought about by intercultural encounters from the late 7th to the 5th century BC through the analysis of organic remains in 133 ceramic vessels found at the Heuneburg using Organic Residue Analysis (ORA). During the Ha D1 phase, fermented beverages, including Mediterranean grape wine, were identified in and appear to have been consumed from local handmade ceramics. The latter were recovered from different status-related contexts within the Heuneburg, suggesting an early and well-established trade/exchange system of this Mediterranean product. This contrasts with the results obtained for the drinking and serving vessels from the Ha D3 phase that were studied. The consumption of fermented beverages (wine and especially bacteriofermented products) appears to have been concentrated on the plateau. The ORA analyses presented here seem to indicate that during this time, grape wine was consumed primarily from imported vessels, and more rarely from local prestigious fine wheel-made vessels. In addition to imported wine, we demonstrate the consumption of a wide variety of foodstuffs, such as animal fats (especially dairy products), millet, plant oils and waxy plants, fruit and beehive products as well as one or several other fermented beverage(s) that were probably locally produced. Through this diachronic study of vessel function from different intra-site contexts, we inform on changing and status-related practices of food processing and consumption

Ghost-in-the-Machine reveals human social signals for human-robot interaction

© 2015 Loth, Jettka, Giuliani and de Ruiter. We used a new method called "Ghost-in-the-Machine" (GiM) to investigate social interactions with a robotic bartender taking orders for drinks and serving them. Using the GiM paradigm allowed us to identify how human participants recognize the intentions of customers on the basis of the output of the robotic recognizers. Specifically, we measured which recognizer modalities (e.g., speech, the distance to the bar) were relevant at different stages of the interaction. This provided insights into human social behavior necessary for the development of socially competent robots. When initiating the drink-order interaction, the most important recognizers were those based on computer vision. When drink orders were being placed, however, the most important information source was the speech recognition. Interestingly, the participants used only a subset of the available information, focussing only on a few relevant recognizers while ignoring others. This reduced the risk of acting on erroneous sensor data and enabled them to complete service interactions more swiftly than a robot using all available sensor data. We also investigated socially appropriate response strategies. In their responses, the participants preferred to use the same modality as the customer's requests, e.g., they tended to respond verbally to verbal requests. Also, they added redundancy to their responses, for instance by using echo questions. We argue that incorporating the social strategies discovered with the GiM paradigm in multimodal grammars of human-robot interactions improves the robustness and the ease-of-use of these interactions, and therefore provides a smoother user experience

Refining and regaining skills in fixation/diversification stage performers: The Five-A Model

Technical change is one of many factors underpinning success in elite, fixation/diversification stage performers. Surprisingly, however, there is a dearth of research pertaining to this process or the most efficacious methods used to bring about such a change. In this paper we highlight the emergent processes, yet also the lack in mechanistic comprehension surrounding technical change, addressing issues within the motor control, sport psychology, coaching and choking literature. More importantly, we seek an understanding of how these changes can be made more secure to competitive pressure, and how this can be embedded within the process of technical change. Following this review, we propose The Five-A Model based on successful coaching techniques, psychosocial concomitants, the avoidance of choking and principles of effective behaviour change. Specific mechanisms for each stage are discussed, with a focus on the use of holistic rhythm-based cues as a possible way of internalising changes. Finally, we suggest the need for further research to examine these five stages, to aid a more comprehensive construction of the content and delivery of such a programme within the applied setting