Advances in the management of HPV-related oropharyngeal cancer

Patients with human papillomavirus- (HPV-) related oropharyngeal squamous cell carcinoma (OPSCC) have a better prognosis than HPV-negative OPSCC when treated with standard high-dose cisplatin-based chemoradiotherapy. Consistent with this assertion and due to younger age at diagnosis, novel approaches tominimize treatment sequelaewhile preserving survival outcomes become of paramount importance. Here, we critically reviewed the evidence-based literature supporting the deintensification strategies in HPV-related OPSCC management, including radiotherapy dose and/or volume reduction, replacement of cisplatin radiosensitising chemotherapy, and the use of transoral surgery. Undoubtedly, further researches are needed before changing the standard of care in this setting of patients

The antiquity of hydrocephalus: the first full palaeo-neuropathological description

The Pathology Museum of the University of Florence houses a rich collection of anatomical specimens and over a hundred waxworks portraying pathological conditions occurring in the nineteenth century, when the museum was established. Clinical and autopsy findings of these cases can still be retrieved from the original museum catalogue, offering a rare opportunity for retrospective palaeo-pathological diagnostics. We present a historical case of severe hydrocephalus backed by modern-day anthropological, radiological and molecular analyses conducted on the skeleton of an 18-month-old male infant deceased in 1831. Luigi Calamai (1796-1851), a wax craftsman of La Specola workshop in Florence, was commissioned to create a life-sized wax model of the child's head, neck and upper thorax. This artwork allows us to appreciate the cranial and facial alterations determined by 30 lb of cerebrospinal fluid (CSF) accumulated within the cerebral ventricular system. Based on the autopsy report, gross malformations of the neural tube, tumours and haemorrhage could be excluded. A molecular approach proved helpful in confirming sex. We present this case as the so-far most compelling case of hydrocephalus in palaeo-pathological research

Beam Loading Compensation of the CTF II Drive Beam using Idle Cavities

A pair of idle cavity structures has been built at the Alfvén Laboratory, KTH, Stockholm for a second order compensation of the drive beam energy spread in the CLIC Test Facility II (CTF II) at CERN, Geneve. In this note, the theoretical background and the cavity design, together with the experimental results, are presented

Analisis Penentuan Harga Jual Dengan Metode Variabel Costing Dan Activity Based Costing Pada PT. Massindo Sinar Pratama Industri

Setiap Perusahaan membutuhkan laba untuk tetap bertahan dan tak mudah untuk mendapatkannya. Dibutuhkan metode dan hitungan yang tepat untuk memperoleh laba tersebut. Tujuan dari penelitian ini adalah untuk mengetahui bagaimana peranan dalam penentuan harga jual dengan menggunakan metode harga pokok variabel dan metode ABC pada PT. Massindo Sinar Pratama Industri. Penelitian ini dilakukan dengan cara pengumpulan data secara deskriptif dan dinyatakan dalam bentuk angka. Setelah menggunakan penghitungan dengan penentuan harga pokok variabel, laba yang diharapkan bisa tercapai sedangkan harga jual per set yang lebih tinggi. Adapun harga jual per set sofa dengan menggunakan metode ABC lebih rendah dibandingkan metode variable. PT. Massindo Sinar Pratama Industri belum menetapkan harga jual yang tepat dan akurat. Cara perhitungan Perusahaan belumlah tepat, sehingga target yang diharapkan tidak terpenuhi. Karena itu, mereka sebaiknya membuat seperangkat metode penerapan harga jual yang ilmiah. Metode ABC hendaknya digunakan dalam penetapan harga jual Perusahaan karena dapat bermanfaat pada perencanaan laba, pengawasan biaya, dan pembuatan keputusan. Manajemen PT. Massindo Sinar Pratama Industri sebaiknya meningkatkan kemampuan produksi divisi sofa sehingga dapat menutupi biaya yang dikeluarkan dan memperoleh laba yang ditargetkan. Kata kunci: variable costing, activity based costing, harga jua

Neural network based prediction of roughing and finishing times in a hot strip mill

The paper presents a model based on neural networks which is able to predict the time required to pass the different gauges of a roughing and finishing mill as function of some slab features and process parameters. The final aim of the work is to increase the rolling efficiency while avoiding collisions and queues that cause time and energy losses. Neural networks are suitable to this prediction task as they are particularly able to cope with unknown non linear relationships between input and output variables. Moreover they can learn from real industrial data and therefore do not require prior assumptions or mathematical modelling of the process and transferability is ensured by the possibility to use different databases coming from different rolling mills. In the paper, two different kinds of neural network- based models have been proposed, their performances have been discussed and compared.En este artículo se presenta un modelo basado en redes neuronales capaz de predecir el tiempo necesario para pasar las diferentes galgas de un tren desbastador y acabador en función de ciertas características del desbaste y parámetros de proceso. El objetivo final es aumentar la eficacia de la laminación evitando colisiones y colas que provoquen pérdidas de tiempo y energía. Se propone utilizar para esta tarea redes neuronales por su capacidad de predicción en aquellos casos en los que existen relaciones no lineales desconocidas entre las variables de entrada y las de salida. Además, son capaces de aprender de datos industriales reales y, por tanto, no requieren suposiciones previas o modelos matemáticos del proceso, estando la transferibilidad asegurada ya que es posible utilizar distintas bases de datos procedentes de diferentes trenes de laminación

Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis

Uterine leiomyosarcoma (LMS) is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center) and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, "local" relapse was observed 5 months after surgery

Assessment of the risk of tuberculosis transmission for five housing prototypes designed for a Haitian community

The hospitalization of patients affected with tuberculosis (TB) can be particularly long and burdensome, especially in poor countries where the disease remains a major issue and beds in health care centres are a precious resource. Therefore a policy of decentralising TB treatment from hospitals to residential environments is starting to be considered worldwide, and new guidelines in support of such strategy are needed. This study illustrates a potential “risk assessment model” for TB transmission in dwellings that might help analysing both existing building stocks and new designs in order to apply the new policy, utilizing as a reference the general frame of risk assessment for buildings developed by civil engineering; the model was then tested on five housing prototypes proposed for the town of Saint Marc, Haiti, showing that environmental features of a building such as ventilation, crowding, temperature and relative humidity are among the most important parameters for the estimate of the risk. The final outcome of the analysis, however, highlighted how he most influential factor on the risk of spread of infectious diseases is the efficiency of the health care system operating in the building urban context

Neuronavigation and intraoperative imaging system in orbital tumor surgery: a review of recent literature

Orbit is a small complex anatomic space that contains important structures, ocular globe, extrinsic muscles, cranial nerves, blood vessels, fat, lacrimal gland. In presence of orbital tumors it is mandatory to use a surgical approach that allows to achieve an adequate surgical field while preserving neurological function. Neuronavigation is the set of computer-assisted technologies used to guide or "navigate” the edges of the tumor to allow the surgeon during resection or biopsy. This technology started with use of CT data to get some landmarks of human anatomy defined “targets” that could be readily used in surgery. Finally, the evolution of modern neuroimaging technologies such intraoperative CT and MRI boosted the surgery accuracy. In order to identify advantages and practical use of these technologies we performed a nonsystematic review of the current literature using the keywords “orbital tumor or orbital neoplasia or orbital mass or orbital lesion” and “neuronavigation or navigation” published in last 10 years. We evaluated 29 papers and we can conclude that navigation in orbital surgery helps to reduce surgical damage while at the same time, allowing a more radical tumor resection. CT and MRI scans are complementary in diagnosing and in intraoperative navigation allow the surgeon to avoid and preserve vital structures, particularly in a complex surgical procedure without real anatomical landmarks for intraoperative orientation. Future is going towards rapid changes and the integration with intraoperative procedures is carrying on to new technologies further our contemporary bounds

Gingival hyperplasia around dental implants in jaws reconstructed with free vascularized flaps: a case report series

Free vascularized flaps are the gold standard for reconstruction of the facial skeleton after surgical ablation of pathologies or when important atrophy of the jaws exists. A frequent problem seen during prosthetic rehabilitation after reconstruction with free vascularized flaps is the onset of hyperplastic granulomatous reactive tissue around the prosthetic abutment of the implant. The features of this phenomenon seem to be directly related to the characteristics of the periimplant tissue and of the manufacturing materials of the prosthesis and abutments. This complication can be seen quite often; we found it in 7 of 40 patients (17.5%). It does not seem to significantly affect the survival rate of implants. The aim of the study was to analyze the behavior of such lesions and to suggest our clinical approach with the management of these kinds of patients and complications. To remove gingival hyperplasia, we used either a traditional cold scalpel or an electric cautery or laser. We had good results using these tools. The onset of this phenomenon was not influenced by either the kind of implant and free flaps used or by the local conditions of the patients (such as radiotherapy). The number of recurrences was highly influenced by the oral hygiene of the patients