Bidirectional gene promoters affect the transcription of two genes, leading to the hypothesis that they should exhibit protection against genetic or epigenetic changes in cancer. Therefore, they provide an excellent opportunity to learn about promoter susceptibility to somatic alteration in tumors. We tested this hypothesis using data from genome-scale DNA methylation (14 cancer types), simple somatic mutation (10 cancer types), and copy number variation profiling (14 cancer types). For DNA methylation, the difference in rank differential methylation between tumor and tumor-adjacent normal matched samples based on promoter type was tested by Wilcoxon rank sum test. Logistic regression was used to compare differences in simple somatic mutations. For copy number alteration, a mixed effects logistic regression model was used. The change in methylation between non-diseased tissues and their tumor counterparts was significantly greater in single compared to bidirectional promoters across all 14 cancer types examined. Similarly, the extent of copy number alteration was greater in single gene compared to bidirectional promoters for all 14 cancer types. Furthermore, among 10 cancer types with available simple somatic mutation data, bidirectional promoters were slightly more susceptible. These results suggest that selective pressures related with specific functional impacts during carcinogenesis drive the susceptibility of promoter regions to somatic alteration.

Stereotactic body radiation therapy (SBRT) is a precise and conformal radiation therapy (RT) that aims to deliver a high dose of radiation to the tumor with sparing surrounding normal tissue, making it an attractive option for head and neck cancer (HNC) patients who are not suitable for traditional long course of RT with comprehensive RT target volume. Definitive SBRT for HNC has been investigated in different settings, including early stage glottis cancer, and as alternative to brachytherapy boost after external beam RT. It also used as a primary treatment option for elderly or medically unfit patients. More recently, SBRT combination with immunotherapy in the neoadjuvant setting for HNC showed promising results. Salvage or adjuvant SBRT for HNC can be used in appropriately selected cases. Future studies are warranted to determine the optimum dose and fractionation schedules in any of these indications.

Spending on out-patient health care by citizens in limited resource countries has received little attention.The purpose of this study is to determine the predictors of household spending on out-patient expenses in a cross-sectional study in Kenya. We applied the GEE methods to determine the effect of various variables on outpatient care. We established that the best predictors for outpatient spending in Kenya are Age of the household head, wealth index, marital status and education, which had the lowest QICu of 976341.2. There were no differences on age in mean spending on outpatient care and was changing in a sinusoidal manner. The rich spend more on outpatient care, due to financial ability. Spending increased across the wealth quantiles while gender had a significant effect in the general performance of the models, it didn’t assist in lowering the QICu

Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) frequently require primary radiochemotherapy (RCT). Despite intensity-modulation, desired radiation-induced effects observed in HNSCC, may also be observed as side-effects in healthy tissue e.g. the sternocleidomastoideus muscle (SCM). These side-effects (e.g. tissue fibrosis) depend on the interval between completion of RCT and restaging-CT. For salvage surgery, the optimal time window for surgery is currently postulated between 6 and 12 weeks after completion of RCT. Thus, no extensive tissue fibrosis is to be expected. This interval is based on studies exploring surgical complications. Studies directly exploring radiation-induced changes of the SCM in HNSCC-patients are sparse. The present study quantifies tissue alterations in SCM and paravertebral musculature (PVM) after RCT applying radiomics to determine the optimal time window for salvage surgery. Three radiomic key parameters 1) volume, 2) mean positivity of pixels (MPP) and 3) uniformity were extracted with mint lesionTM in the staging-CTs and restaging-CTs of 98 HNSCC-patients. Of these, 25 were female, the mean age was 62 (±9.6) years and 80.9% were UICC Stage IV. The mean restaging-interval was 55 (±28; range29-229) days. Only the mean volume significantly decreased after RCT from 9.0 to 8.4 and 96.5 to 91.9 ml for SCM and PVM, respectively (both p=0.007, both Cohen’s d=0.28). In addition, the mean body mass index (BMI) decreases from 23.9 (±4.2) to 21.0 (±3.6) kg/m² (p<0.001); Cohen's d = 0.9). The mean BMI-decrease significantly correlated with the volume decrease for SCM (r=0.27; p=0.007) and PVM (r=0.41; p<0.001). If t-test p-values were adjusted for the BMI-decrease, no significant change in volumes for SCM and PVM was observed (both p>0.05). The present data supports the postulated optimal interval for salvage surgery of 6 to 12 weeks. Irrespective of the remaining risk-benefit ratio of salvage surgery, the risk of additional surgical complications due to fibrosis is not supported by the present observations.

Passive dynamics is an aspect of locomotion which is entirely dependent on the mechanical configuration and linkages of adjacent body segments. Tension distribution along mechanical linkages enables execution of movement patterns with reduced need for complex neurological pathways and may play a role in reestablishing postural stability following external disturbances. Here we demonstrate a uni-directional mechanical relationship between the equine forelimb, head and neck, which may have implications for balance and forelimb loading in the horse. These observations suggest that forelimb, head and neck movement coordination (observed in the horse during unrestrained locomotion) is largely controlled by the mechanical linkages between body segments, rather than being entirely dependent on neurological input as previously thought. This highlights the potential significance of research directed at investigating passively induced movements in understanding common locomotory patterns. Additionally, it suggests a mode of postural control which may provide instantaneous adjustments to postural disturbances, thus promoting rapid and efficient locomotion.

Background: We aimed to study the frequency, management, and outcomes of patients with blunt pancreatic trauma. Methods: We reviewed the medical records for all patients admitted with pancreatic injuries between 2011 and 2017 at the only level 1 trauma center in the country. Results: There were 71 patients admitted with pancreatic trauma (0.6% of trauma admissions and 3.4% of abdominal injury admissions) with a mean age of 31 years. Sixty-two patients had pancreatic injury grade I-II and 9 had grade III-IV. Thirty-eight percent had GCS <9 and 73% had ISS >16. The level of pancreatic enzymes was significantly proportional to the grade of injury. Over half of patients required a laparotomy, of them 12 patients had an intervention on the pancreas. Eight patients developed complications related to pancreatic injuries ranging from pancreatitis to pancreatico-cutaneous fistula while 35% developed hemorrhagic shock. Mortality was 31% and regardless of the grade of injury, the mortality was associated with high ISS, low GCS and presence of hemorrhagic shock. Conclusion: Pancreatic injuries following blunt trauma are rare and the injured subjects are usually young male. However, most injuries are of low-grade severity. This study shows that shock, higher ISS and lower GCS are associated with worse in-hospital out-comes. Non-operative management may suffice in patients with lower grade injuries, which may not be the case in patients with higher grade injuries unless carefully selected

Importance: The rapidly expanding 2019 novel coronavirus pandemic (COVID-19, caused by the SARS-CoV-2 virus) has challenged the medical community to an unprecedented degree. Physicians and healthcare workers are at added risk of exposure and infection during the course of the patient care. Due to the rapid spread of this disease through respiratory droplets, healthcare providers such as otolaryngologists-head & neck surgeons who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures are particularly at risk. Here we present a set of safety recommendations based on our review of literature and communications with physicians with first-hand knowledge of safety procedures during the 2019 COVID-19 pandemic.Observations: A high number of healthcare providers were infected during the first phase of the pandemic in Wuhan province. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for healthcare providers without jeopardizing the care of patients. We reviewed the most common procedures related to the examination and treatment of upper aerodigestive tract diseases. Each category was reviewed based on the potential risk imposed to healthcare workers. Specific recommendations were made, based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in COVID-19 patients. Conclusions and Relevance: Preserving highly skilled healthcare work force is a top priority for any community and healthcare system. Based on the experience of healthcare systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of healthcare providers could be significantly reduced, while providing high levels of care. The provided recommendations could be used as broad guidance for all healthcare workers who are involved with the care of COVID-19 patients.

Head and neck cancers arise from mucosa lining the oral cavity, oropharynx, hypopharynx, larynx, sinonasal tract, and nasopharynx and the etiology of head and neck cancers is complex and involves many factors, among which oncogenic viruses are also enumerated. Nevertheless, this type of cancers are among the most common cancers around the world. The thorough knowledge of the pathogenesis of viral infection is needed to fully understand its impact on cancer development.

The cyclooxygenase-2 (COX-2) is a potent enzyme that converts arachidonic acid to prostaglandins (PG), including PGE2, a key mediator of inflammation and angiogenesis. Importantly, COX-2 is activated in response to inflammatory stimuli, where it is also believed to promote the development and progression of head and neck cancers (HNC). COX-2 can mediate its protumorigenic effect through various mechanisms such as inducing cell proliferation, inhibition of apoptosis, and suppressing the host’s immune response. Furthermore, COX-2 can induce the production of vascular endothelial growth factors, hence promoting angiogenesis. Indeed, the ability of COX-2 inhibitors to selectively restrict the proliferation of tumor cells and mediating apoptosis provides promising therapeutic targets for cancer patients. Thus, in this comprehensive review, we summarized the reported differential expression patterns of COX-2 in different stages of head and neck carcinogenesis—from potentially premalignant lesions to invasive carcinomas. Furthermore, we examined the available meta-analysis evidence for COX-2 role in the carcinogenesis of HNC. Finally, further understanding of the biological processes of COX-2 and its role in orchestrating cell proliferation, apoptosis and angiogenesis may give therapeutically beneficial insight to develop the management plan of HNC patients and improve their clinical outcomes.

The twelve cranial nerves play a crucial role in nervous system, orchestrating a myriad of functions vital for our everyday life. These nerves are each specialized for particular tasks. Cranial Nerve I, known as the olfactory nerve, is responsible for our sense of smell, allowing us to perceive and distinguish various scents. Cranial Nerve II, or the optic nerve, is dedicated to vision, transmitting visual information from the eyes to the brain. Eye movements are governed by Cranial Nerves III, IV, and VI, ensuring our ability to track objects and focus. Cranial Nerve V controls facial sensation and jaw movement, while Cranial Nerve VII, the facial nerve, facilitates facial expressions and taste perception. Cranial Nerve VIII, or the vestibulocochlear nerve, plays a critical role in hearing and balance. Cranial Nerve IX, the glossopharyngeal nerve, affects throat sensation and taste perception. Cranial Nerve X, the vagus nerve, is a far-reaching nerve, influencing numerous internal organs such as the heart, lungs, and digestive system. Cranial Nerve XI, the accessory nerve, is responsible for neck muscle control, contributing to head movement. Finally, Cranial Nerve XII, the hypoglossal nerve, manages tongue movement, essential for speaking, swallowing, and breathing. Understanding these cranial nerves is fundamental in comprehending the intricate workings of our nervous system and the functions that sustain our daily lives.

Engine Overheating is a condition where the engine temperature has increased above the working temperature. This analysis aims to analyze the damage, determine the factors causing the damage, identify corrective steps and prevent engine overheating. The inspection procedure is carried out by checking the cooling system's components, cylinder head, and cylinder block. Further analysis using a fishbone diagram to analyze the causes of engine overheating troubleshooting. Damage analysis results Engine overheating occurs because the thermostat is damaged, namely, the thermostat valve which cannot open when the temperature reaches the standard temperature (71oC), and also due to damage to the cylinder gasket which causes bubbles due to compression leaks and mixing of radiator coolant and oil. Repair steps are taken in the form of replacing damaged components with new ones. Preventive measures are taken by not using the unit on an over-running basis, checking coolant levels, carrying out daily checks properly and correctly, and carrying out preventive maintenance regularly.

Cytoglobin has been implicated in a range of pathological conditions including fibrosis and cancer, where cytoglobin expression is linked to hypoxia- and drug-resistance. One disease where there is evidence of a role for cytoglobin is head and neck squamous cell carcinoma, a disease with a poor prognosis and where clinical resistance to platinum-based drugs is common. In the current study, we demonstrate that 3D-culture of head and neck cancer cells (PE/CA-PJ41, Liv-22K) and normal oral keratinocyte cells (NOK-hTERT) results in changes in sensitivity to cisplatin cytotoxicity compared to 2D-cultures. Relative to 2D-cultures, 3D-cultures of PE/CA-PJ41 and NOK-hTERT cells demonstrated increased cisplatin resistance. In contrast, 3D-cultures of Liv-22K cells were more sensitive to cisplatin. Evidence for cisplatin genotoxicity was observed in the form of GADD45A activation in PE/CA-PJ41 cells but not the other two cell types investigated. Furthermore, DNA-strand breaks were also detected by the alkaline comet assay in PE/CA-PJ41 cells although levels were not significantly affected by 3D-culture. Cytoglobin expression levels were elevated by 3D-culture in all three cell lines investigated and there were also changes in expression of genes related to cell division (MKI57, GJB6), cell adhesion (CDH1), stress response (NFkB, NQO1) and apoptosis (Casp3) but these changes were cell line specific. We also observed consistent transcriptional activation of HIF1a in 3D-cultures of all three cell lines, suggestive of hypoxic conditions in spheroids. In support of a direct role of hypoxia in cytoglobin induction, the HIF1a stabiliser cobalt chloride also induced cytoglobin expression in spheroids. Transcriptomic profiling of PE/CA-PJ41 cells over-expressing cytoglobin identified 121 differentially regulated genes, when cells were cultured under hypoxic conditions. Major changes identified included, upregulation of G1/S cell cycle regulation as well as wnt- and RhoGTPase-signalling pathways. In conclusion, 3D-cultures are a useful model to further study the biological function of cytoglobin in head and neck cancer and we provide evidence that further supports a role for cytoglobin in hypoxia-dependent cellular proliferation and phenotypic changes that could contribute to cisplatin resistance in vivo.

Deoxynivalenol (DON) is a mycotoxin produced by Fusarium spp. that causes Fusarium head blight (FHB) disease in cereal crops. Ingestion of food contaminated with DON poses serious human health complications. However, the DON cytotoxicity has been mostly deduced from animal studies. In this study, we used the nematode Caenorhabditis elegans (C. elegans) as a tractable animal model to dissect the toxic effect of DON. Our results indicate that DON reduces the fecundity and lifespan of C. elegans. The real-time RT-PCR analysis showed that DON upregulates innate immunity-related genes including C17H12.8 and K08D8.5 encoding PMK-1 (mitogen activated protein kinase-1)-regulated immune effectors, and F35E12.5 encoding a CUB-like domain-containing protein. Furthermore, our RNAseq data demonstrate that out of ~ 17,000 C. elegans genes, 313 are upregulated and 166 were downregulated by DON treatment. Among the DON-upregulated genes, several are ugt genes encoding UDP-glucuronosyl transferase (UGTs) which are known to be involved in chemical detoxification. The three upregulated genes, F52F10.4 (oac-32), C10H11.6 (ugt-26) and C10H11.4 (ugt-28) encoding the O-acyltransferase homolog, UGT26 and UGT 28, respectively, are shown to contribute to DON tolerance by RNAi bacterial feeding experiment. The results of this study provide insights to the targets of DON cytotoxicity and potential mitigation measures.

Arthroscopic capsular release (ACR) is used for persistent shoulder stiffness after an index surgery. No cases of post-ACR humeral head osteonecrosis have been reported to date. A 56-year-old male patient underwent open reduction and internal fixation using a hook plate for acromioclavicular joint dislocation. Despite hardware removal, the patient presented with unresolved shoulder pain and range-of-motion (ROM) limitation. He had a history of hypertension, chronic hepatitis B infection, and alcohol consumption. Preoperative ROM was forward flexion 90°and internal rotation sacral level. Preoperative functional status was visual analog scale (VAS) score 4, American Shoulder and Elbow Surgeons (ASES) score 51, and Constant–Murley (CMS) score 48, and normal radiography and magnetic resonance imaging. Standard ACR was performed with 360° release of the joint capsule via electrocautery ablation. Six-months post-ACR, ROM (forward flexion: 135°, abduction: 135°, external rotation: 70°, internal rotation: T10 vertebra) and functional outcomes (VAS 2; ASES79; CMS 75) were significantly improved, without interval change in radiographic assessment. However, 21 months later, he had recurrent shoulder pain and decreased ROM. Radiography revealed humeral head osteonecrosis. Patients with intrinsic or extrinsic risk factors related to humeral head circulation disturbance should be monitored for humeral head osteonecrosis post-ACR.

The Atlantic puffin is a medium-sized seabird with black and white plumage and orange feet. It is distributed mainly along the northern Atlantic Ocean and due, among other reasons, to human activities, it is in a threatened situation and classified as a vulnerable species according to the International Union of Conservation of Nature (IUCN). In this study, we used a total of 20 carcasses of juvenile Atlantic puffins to perform anatomical cross sections and magnetic resonance images. Thus, an adequate description of the head was made, providing valuable information that could be helpful as a diagnostic tool for veterinary clinicians, who increasingly treat these birds in zoos, rehabilitation centers and even in the wild.

This study assessed the relationship between head posture displacements and biomechanical parameters in three different tasks. One hundred male and female students (20 ± 3yrs) were assessed via the PostureScreen Mobile app to quantify postural displacements of head rotations and translations including: 1) the cranio-vertebral angle (CVA) (°), 2) anterior head translation (AHT) (cm), 3) lateral head translation in the coronal plane (cm), and 4) lateral head side bending (°). Biomechanical parameters during gait and jumping were measured using the G-Walk sensor. The assessed gait spatiotemporal parameters were cadence (steps / min), speed (m / s), symmetry index, % left and right stride length (% height), and right and left propulsion index. The pelvic movement parameters were: 1) tilt symmetry index, 2) tilt left and right range, 3) obliquity symmetry index, 4) obliquity left and right range, 5) rotation symmetry index, and 6) rotation left and right range. The jump parameters measured were: 1) flight height (cm), 2) take off force (kN), 3) impact Force (kN), 4) take off speed (m / s), 5) peak speed (m / s), 6) average speed concentric phase (m / s), 7) maximum concentric power (kW), 8) average concentric power (kW) during the counter movement jump (CMJ), and 9) CMJ with arms thrust (CMJAT). At a significance-level of p ≤ 0.001, moderate to high correlations (0.4 &lt; r &lt; 0.8) were found between CVA, AHT, lateral translation head and all the gait and jump parameters. Weak correlations (0.2 &lt; r &lt;  0.4) were ascertained for lateral head bending and all the gait and jump parameters except for gait symmetry index and pelvic symmetry index, where moderate correlations were identified (0.4 &lt; r &lt; 0.6). The findings indicate moderate to high correlations between specific head posture displacements, such as CVA, lateral head translation and AHT with the various gait and jump parameters. These findings highlight the importance of considering head posture in the assessment and optimization of movement patterns during gait and jumping. Our findings contribute to the existing body of knowledge and may have implications for clinical practice and sports performance training. Further research is warranted to elucidate the underlying mechanisms and establish causality in these relationships, which could potentially lead to the development of targeted interventions for improving movement patterns and preventing injuries.

Cancers of the head and ne¬ck and their treatment can cause disfigurement and loss of functioning, with a profound negative impact on the person’s self-image and psychosocial wellbeing. This can lead to experiences of shame and stigma, which are important targets for psychosocial interventions. Accurate measurement and identification of these problems enables clinicians to offer appropriate interventions and monitor patients’ progress. This study aimed to validate the Canadian version of the Shame and Stigma Scale (SSS) among French and English speaking head and neck cancer patients. Data from 258 patients from two major Canadian hospitals was analysed. The existing 4-factor structure of the SSS was supported, with the following subscales: Shame with Appearance, Sense of Stigma, Regret, and Social/Speech Concerns. The Canadian SSS showed adequate convergent and divergent validity and test-retest reliability. Rasch analysis suggested scale improvement by removing two misfitting item and two items with differential functioning between French and English speaking patients. The final 16-item scale version had adequate fit to the Rasch model. The SSS provides more accurate measures for people with high levels of shame and stigma, and thus has utility in identifying patients with more severe symptoms who may be in need of psychosocial interventions.

Chemoradiotherapy (CRT) is the standard treatment for locally advanced head and neck cancer; however, CRT may cause post-treatment dysphagia. Transcutaneous electrical sensory stimulation (TESS), developed in recent years for swallowing rehabilitation, has been used at many medical facilities. Although TESS has been used for dysphagia in several fields, its safety and efficacy in patients with head and neck cancer remain to be clarified. Therefore, this study evaluated the safety of TESS in ten patients with head and neck cancers undergoing CRT. Swallowing rehabilitation intervention and TESS implementation were performed for all patients during CRT. Non-blood toxicity adverse events (AEs), such as dermatitis and mucositis, occurred during CRT; however, the severity was less than Grade 3. No patient experienced pain due to TESS. As survival time analysis using the Kaplan–Meier method for interferential current device implementation rates revealed a feasibility of 100% for up to 60 Gy and a feasibility of 78% for up to 70 Gy, it concludes that TESS was feasible until 70 Gy. This study confirmed the feasibility and safety of TESS in the head and neck region, even during CRT. Although the precise mechanism of TESS on dysphagia is not yet clear, its continued use has great potential for improving sensory disturbance.

Chondrosarcoma, represents approximately 0.1% of all neoplasms of the head and neck, being considered a rare disease, but with a relatively good prognosis. The 5-year overall survival (OS) rate is estimated at 70-80%, being considered a disease with a low growth rate. About 13% of all cases of chondrosarcoma, are located in the region of the head and neck. We present the case of a young patient treated multimodally, lost from the oncological records less than two years after the diagnosis, without evidence of disease progression. The early loss from the oncological follow-up programs of patients with a lower risk of early repalpse, without evidence of a recurrence or metastasis could be the consequence of a major complication among which we could assume an aspiration pneumonia secondary to a dysphagia, associated with an aggressive multidisciplinary treatment. Large tumor size and positive resection margins (R1 resection) are risk factors that support an intensive adjuvant approach in order to reduce the risk of recurrence, but the low grade of tumor, associating a lower risk of recurrence as well as the adverse events (AE) of adjuvant radiotherapy and chemotherapy justifies a more reserved therapeutic approach. Taking into account the longer life expectancy of these patients, it is recommended to use a more conformal irradiation technique in order to reduce doses to radiosensitive structures as well as to omit elective neck irradiation, taking into account the lower risk of lymph node involvement. The lack of guidelines that include very rare tumors including low grade chondrosarcoma of head and neck make a unified approach difficult, but the data presented even in case reports could contribute to choosing the regimen that offers the best therapeutic ratio.

Oculomotor Dysfunctions (OMDs) are problems with eye-musculature relating to coordination and accuracy of eye movements. Eye-tracking (ET) technologies show great promise in the identification of OMDs. Current computer technologies for vision screening are specialized devices or laptop based technologies with limited by screen size and the inability to measure depth. In this experimental study, we examine the possibilities of immersive virtual reality (VR) technologies for increased user experiences, presence, immersiveness, and the use of serious games. Further results of an experimental study present increased interest in VR-based screening, its ability to focus better, and aspects motivating for its use, despite the actual limitations of current technologies. These limitations currently include lower performance and confidence in results of the used HMDs. Some users also describe being more focused when screening in VR, free from outside distractions. Using serious games for screening in VR is also estimated to have great potential for developing a more robust vision screening tool, especially for younger children.

Most head and neck cancers are diagnosed in advanced stages, when the curative interventions are no longer possible. The assessment and the multidisciplinary therapeutic approach of the locally advanced cases are difficult since the onset of the disease becomes a significant challenge for the whole attending team (including both the patient and his family) because they have to deal with to an extensive symptomatology (abundant secretions, refractory pain, mutilations predominantly in the cephalic area), with the cure of stomas (tracheostomy, gastrostomy) and with various post-therapeutic sequelae. The present paper reflects the impact of late diagnosis, the complexity of the multimodal specific oncological treatment (chemotherapy, radiotherapy, immunotherapy, pal-liative and terminal treatment), the adaptation of medical care to the psycho-emotional structure, having as an example the case of 54-year old patient (with his consent) diagnosed with pharyn-golaryngeal neoplasm who presented himself to “St. Luca” Chronic Disease Hospital, the Oncol-ogy-Palliative Care Department, in September 2021. In patients with locally advanced head and neck cancers, besides the specifically oncological therapeutic decisions, the empathic-emotional connection between the medical team with the patient and his family plays a key role in the ther-apeutic conduct.

Fusarium Head Blight (FHB) is a destructive disease affecting the grain yield and quality of wheat, barley, rye and triticale. Developing varieties with genetic resistance is integral to successfully managing FHB. However, significant knowledge gap exists in the genetic diversity present in triticale for FHB resistance. This information is critical for breeding new varieties of triticale as its production continues to increase. In the present study, a set of 298 winter triticale accessions from a worldwide collection were screened for their type-2 FHB resistance in an artificially inoculated misted nursery with high levels of inoculum density. Most of the triticale accessions were susceptible to FHB, and only 8% of accessions showed resistance in the field nursery screening. The resistant accessions identified in the nursery screening were selected and further screened for three years in greenhouse conditions. Seven accessions were found to show robust FHB resistance over the three years of greenhouse testing. Thirteen accessions showed significantly lower levels of Deoxynivalenol accumulation when compared to the susceptible triticale control. The accessions identified in the study will be useful in triticale and wheat breeding programs for enhancing FHB resistance and reducing DON accumulation.

Abstract: Background: Intensity modulated radiotherapy (IMRT) is still a standard of care for radiotherapy in locally advanced head and neck cancer (LA-HNSCC). Simultaneous integrated boost (SIB) and moderate hypofractionation offer an opportunity for individual dose painting and a reduction in overall treatment time. We present retrospective data on toxicity and locore-gional control of a patient cohort with LA-HNSCC treated with an IMRT-SIB concept in compar-ison to normofractionated 3D-conformal radiotherapy (3D-RT) after a long-term follow-up. Methods: Between 2012 and 2014, n=67 patients with HNSCC (stages III/IV without distant me-tastases) were treated with IMRT-SIB either definitively (single/total doses: 2.2/66 Gy, 2.08/62.4 Gy, 1.8/54 Gy in 30 fractions) or in the postoperative setting (2.08/62.4 Gy, 1.92/57.6 Gy, 1.8/54 Gy). These patients' clinical courses were matched (for sex, primary, and treatment concept) as part of a matched-pair analysis with patients treated before mid-2012 with normofractionated 3D-CRT (definitive: 2/50 Gy followed by a sequential boost up to 70 Gy; postoperative: 2/60-64 Gy). Chemotherapy/ immunotherapy was given concomitantly in both groups in the definitive situation (postoperative dependent on risk factors). The primary endpoints were acute and late toxicity; the secondary endpoint was locoregional control (LRC). Results: Sixty-seven patients treated with IMRT-SIB (n = 20 definitive, n = 47 adjuvant) were matched with 67 patients treated with 3D-RT. There were minor imbalances between the groups concerning nonmatching variables such as extracapsular extension (ECE) and chemotherapy in IMRT-SIB. Significantly less toxicity was found in favor of IMRT-SIB concerning dysphagia, ra-diation dermatitis, xerostomia, fibrosis, and lymphedema. After a median follow-up of 63 months, the median LRC was not reached (IMRT-SIB) vs. 69.5 months (3D-RT) (p=0.63). Conclusions: This moderately hypofractionated IMRT-SIB concept was shown to be feasible with less toxicity than conventional 3D-RT in this long-term follow-up observation.

Background: The main factors to influence on the stroking performance of club head are alloy and spring-like effect. Design the structure of new club face to create the fairway wood which can show best stroking feeling and let driving distance become longer. Purpose: The club face of fairway wood is processed through the iron alloy heating procedure and CNC to innovate the club head with high spring-like effect (characteristic time). Method: (1) Use 455 stainless steel processed by heating and aging treatment, to do the analysis on microstructure and mechanical properties. (2) Through CNC to design seven different patterns for the back of club face, each pattern for three club head. The total amount is twenty-one. (3) Make finished product be test the characteristic time and the ability of strike by the practical measurement. (4) To analyze after the compare between three-way ANOVA and LSD. Results: After 455 stainless steel was heated in procedure S850℃-A550℃, mechanical properties became superior and had the better malleability, it is suitable for developing the club face of high spring-like effect. Before and after grinding among three-way ANOVA (pattern*thickness*place), did not achieve the significant level on the figure of characteristic time. Through two-way ANOVA (pattern*place and thickness*place), showed the significant deviation before and after grinding. After doing the crash test by 45m/s, all the results can reach the higher limited standard. Summary: 455 stainless steel was designed with the different club face’s thicknesses of fairway wood can make spring-like effect achieve high characteristic time. The much thinner club face let the characteristic time perform highly. But there was no obvious effects from the patterns of the back club face.

Fusarium head blight (FHB) disease is extensively distributed worldwide. This disease damages grain quality and reduces yield. The detection of this disease in a high throughput way is crucial to planters and breeders. Our study focused on developing a method for processing wheat color images and accurately detecting disease areas using deep learning and image processing techniques. The color images of wheat at the milky stage were collected and processed to construct datasets, which were used to retrain a deep convolutional neural network model using transfer learning. Testing results showed that the model can detect spikes, and the coefficient of determination of the number of spikes between the manual count and the detection was 0.80. The model was assessed, and the mean average precision for the testing dataset was 0.9201. On the basis of the results of spike detection, a new color feature was applied to obtain the gray image of each spike. Then, a modified region growing algorithm was implemented to segment and detect the diseased areas of each spike. Results show that the region growing algorithm performs better than K-means and Otsu’s method in segmenting the FHB disease. Overall, this study demonstrates that deep learning techniques enable the accurate detection of FHB in wheat using color images, and the proposed method can effectively detect spikes and diseased areas, thereby improving the efficiency of FHB detection.

The aim of the study was to determine the presence Fusarium species and mycotoxins in winter wheat grain in Poland. Grain samples from different locations in Poland in 2009 and 2010 were analysed for the content of biomass of Fusarium species and mycotoxins. In 2009 biomass of F. graminearum and F. poae was present in all samples, F. culmorum in 82% of samples, F. avenaceum in 55% of samples. F. sporotrichioides, F. tricinctum and F. equiseti were found only in individual samples. F. langsethiae was not detected. In 2010, five Fusarium species were detected with the exception of F. sporotrichioides. The highest content of biomass was found for F. graminearum followed by F. avenaceum, F. poae and F. langsethiae. The amount of F. culmorum biomass was very low. The most frequently occurring species was F. poae and F. graminearum. In 2009, deoxynivalenol was detected in all samples. In 2010, the average content of deoxynivalenol was lower than in 2009. Nivalenol was detected at very low concentration in both years. Significant correlations between content of F. graminearum biomass and deoxynivalenol concentration in grain and between content of F. poae biomass and nivalenol concentration in grain in 2009 were found. The most important finding of this study was that main Fusarium species infecting wheat kernels in Poland in both years was F. graminearum. The amount of biomass of F. graminearum was the highest in both years. It was present in the most samples. The other frequently detected species was F. poae, which in 2010 appeared in more samples than F. graminearum. However, the amount of F. poae biomass was lower. F. culmorum, species that was previously dominating as wheat pathogen in Poland, was found less frequently than F. graminearum. The amount of biomass of this species was the lowest in 2010.

Abstract. Leiomyoma is a benign tumour of smooth muscle cells classified into three groups: solid leiomyoma, angioleiomyoma and leiomyoblastoma. Angioleiomyoma arises from the tunica media of veins and arteries of vascular smooth muscle.Nasal cavity, paranasal sinus and oral cavity are the most frequent locations in Head and Neck region. Here we present the case of a tongue base angioleiomyoma with an emphasis on clinical data, pathologic findings and surgical approach. The patient complained about a one-month of globus sensation, dysphagia and hemoptysis without other systemic symptoms. Laryngoscopy revealed the presence of a 2 cm solitary submucosal mass located on the left tongue base covered with normal mucosa. The patient underwent direct laryngoscopy to perform a biopsy for the purpose of achieving the conclusive diagnosis. Treatment options were discussed, included surgical resection. Transoral robot-assisted resection was performed without complications. Clearly the description of our case does not want to have a purpose in terms of indications but wants to describe the possibility of considering TORS in the case of benign tumours of the tongue base, especially in cases like this where a standard technique can difficulty be achieved. Current literature review was provided and discussed.

Weight and age interact to modify cognitive effects of head acceleration events after two seasons of youth football Abstract This is a follow-up study of youth American football players in a second season of play. Season-one findings identified a relationship between a head acceleration measure (HITsp) and cognitive score changes with weight modifying the effect in 9 to 10 year-olds. Sixty-eight youth completed a second season of play wearing helmet-mounted sensors and were assessed with neuropsychological tests pre- and post-season. Regression analysis of the full sample demonstrated a small but significant negative effect of HAE on cognition as indexed by test score changes: R2 = .06, F = 4.06, p = .024. Outcome differences between those who started playing at ages nine to 10, compared to those who started between 11 and 13 were identified: t(66) = -3.39, p<.01, d = -.84, 95th CI -2.77 to -.72. Regression models including players’ weights found that the relationship of weight to outcome was different by group: greater negative cognitive effects were found in younger-heavier players (R2 = 0.21, F =3.21, p = 0.03) and older-lighter players (R2 = 0.18, F =4.26, p <.001). These findings confirmed a negative relationship of HAE and cognitive change and point to player weight as an important developmental factor to consider in understanding concussion biomechanics.

BACKGROUND: Head and Neck Sarcomas (HNSs) are rare malignant tumors derived from mesenchymal cells characterized by rapid growth, local aggressive behavior, and multiple re-lapses. The Rhabdomyosarcoma (RMS) and the Osteosarcoma (OS) are the more frequent HNS. The present study aims to evaluate the clinical impact of multimodal treatment in patients diagnosed with HNS. METHODS: A retrospective analysis of medical records from patients diagnosed with HNS multimodal treated, four groups were formed: a) surgery and chemotherapy (CTX); b) surgery, CTX, and RT; c) surgery and RT; d) CTX and RT exclusively. The overall survival (OSS), disease-free survival (DFS) and progression-free survival (PFS) rates were calculated using the Kaplan-Meier test. RESULTS: Among 39 patients, 23.1% were diagnosed with RMS , 66.7% with OS and 10.3% with other subtypes of HNS. Moreover, 59% showed initial clinical staging (T1/T2) and of those 35.9% were T1. Surgery was performed in 87.2% patients, RT in 35.9% and CTX in 84.7%. RT performed showed not statistically significant clinical role regarding OSS (p=0.74), DFS (p=0.09) and PFS (p=0.90) rates independent of histological subtype. Finally, OSS (p=0.89), DFS (p=0.13) and PFS (p=0.50) rates were not statistically different for patients treated with monotherapy or multimodal therapy. CONCLUSION: RT has not showed a clinically important role referred to improve OSS, DFS and PFS rates in patients with HNS, regardless of the histological subtype of the primary tumor. Multimodal treatment could influence in survival rates and locoregional control of the disease; however, longitudinal studies such as randomized clinical trials must be conducted.

Researchers achieved high torque volume ratios in magnetorheological (MR) fluid braking devices by introducing multiple layers and multiple poles concepts. The number of magnetic poles, pole geometry and placement have a significant effect on these multi-pole MR brake performances. This research work focused on the effect of the pole head geometry in a multi-pole dual-disc MR brake for the enhancement of braking torque. The magnetic field generated by the electromagnetic coil has to penetrate through pole heads and travel orthogonally through the rotor and MR fluid layers to achieve maximum brake torque. This flow depends on the profiles of the magnetic pole head area and corresponding core dimensions. This study considered pentagon, square, hexagon, trapezoid and ellipse pole head profiles in place of the conventional circular pole and the best possible core dimensions were used for each geometry. A three-dimensional electromagnetic analysis of the MR brake is conducted to simulate the brake performance. Results showed that the hexagonal and elliptical pole heads are having better magnetic field area, magnetic intensity distribution and higher magnetic flux lines piercing through the MR fluid perpendicularly than the circular and square pole heads. An increment of 3.88% for braking torque performance is obtained, and the braking torque is significantly enhanced.

Detecting human head movement during sleep is important as it can help doctor to access some physical or mental health problems like infantile eczema, calcium deficiency, insomnia, anxiety disorder and even Parkinson’s disease, and provide useful clues for scientific diagnosing. To obtain the information of sleep head movement, current solutions either use the camera or require the user to wear intrusive sensors to collect the image or motion data. However, the vision-based schemes depend on the environmental light conditions and also bring privacy concerns. Some people including the elderly and infant may be reluctant to wear wearable devices during sleep. In this paper, we propose a novel system called Wi-Senser to address the issues mentioned above. Our Wi-Senser directly reuses the existing WiFi infrastructure and exploits the fine-grained channel state information (CSI) of WiFi signals to capture the minute human head movement during sleep without attaching any sensors to the human body. We design and implement our system with just one commercial off-the-shelf (COTS) router and one laptop equipped with Intel 5300 network interface card (NIC). We evaluate the performance of Wi-Senser with 6 volunteers (4 adults and 2 children). Extensive experiments demonstrate that Wi-Senser can achieve a 98.5% accuracy for head movement detection during sleep. Wi-Senser provides a new solution for achieving noninvasive, continuous and accurate human minute movement detection without any additional cost.

In foggy weather scenarios, the scattering and absorption of light by water droplets and particulate matter cause object features in images to become blurred or lost, presenting a significant challenge for target detection in autonomous driving vehicles. To tackle this problem, this study proposes a foggy weather detection method, YOLOv5s-Fog, based on the YOLOv5s framework. The model enhances the feature extraction and expression capabilities of YOLOv5s by introducing a novel target detection layer, SwinFocus. Additionally, this research incorporates decoupled head into the model and replaces the conventional non-maximum suppression method with Soft-NMS. Experimental results demonstrate that these improvements effectively enhance the detection performance for blurry objects and small targets in foggy weather conditions. Compared to the baseline model YOLOv5s, YOLOv5s-Fog achieves a 5.4% increase in mAP on the RTTS dataset, reaching 73.4%. This method provides technical support for rapid and accurate target detection in adverse weather conditions, such as foggy weather, for autonomous driving vehicles.

Oral mucositis (OM) is inflammation of the mouth caused by damage to the mucous membranes that line the mouth and throat. It is a side effect of cancer treatment, particularly in patients with head and neck squamous cell carcinoma (HNSCC) who undergo radiotherapy, chemotherapy, and/or immunotherapy with immune checkpoint inhibitors. The etiology and pathogenic mechanisms of OM is complex and multifaceted, involving cytotoxicity (cell death), inflammation, infection, change in microbiome, and immune-mediated cytotoxicity. We summarize the literature about attempts to use various omics methodologies (genomics, transcriptomics, microbiomics and metabolomics) to elucidate the biological pathways associated with the development or the severity of OM. Integrating different omics into multi-omics approaches carries the potential to discover links among host factors (genomics), host responses (transcriptomics, metabolomics), and local environment (microbiomics).

Background: Sinonasal squamous cell carcinoma (SNSCC) is rare in the general population. No clear and consistent etiologic correlation between human papillomavirus and SNSCC has yet been delineated in literature. p16 is a tumour suppressor protein used as a surrogate marker for HPV. This study aims to evaluate the relationship between p16 overexpression in SNSCC and its role in prognosis and survival. Methods: A population-based retrospective analysis was performed using prospectively collected data from the Northern Alberta Head and Neck Tumour Board, Alberta Cancer Registry, and Alberta Cancer Research Biobank. p16 overexpression was analyzed from pathologic sample of patients meeting study criteria, and participants were dichotomized by status. Subsequently, nonparametric analysis of demographics, initial staging, and initial treatment were performed, and a Kapan-Meier curve was developed to assess differences in survival. Results: 16 patients were included in analysis. p16 overexpression was seen in 68.8% of patients. p16 positive and negative groups were comparable for age, gender, smoking status, stage, and treatment. A statistically significant five-year survival advantage was observed in patients with p16 positive SNSCC (p = 0.013). Conclusions: This is the first Canadian study to demonstrate a high prevalence of p16 positivity in SNSCC and its presence denoting a statistically significant survival advantage. Results demonstrate a previously unconfirmed role of oncogenic HPV in SNSCC.

Fusarium head blight (FHB) can cause contamination of cereal grain with mycotoxins. Triticale is also infected with FHB; however, it is more resistant than wheat to head infection. The aim of this study was to identify triticale lines that combine low head infection with low toxin contamination. Resistance to FHB of 15 winter triticale and three winter wheat lines was evaluated over a three-year experiment established in two locations. At the anthesis stage, heads were inoculated with Fusarium culmorum isolates. The FHB index was scored and the percentage of Fusarium-damaged kernels (FDKs) assessed. The grain was analysed for type B trichothecenes (deoxynivalenol and derivatives, nivalenol) and zearalenone content. The average FHB index was 10.7%. The proportion of FDK was 18.1% (weight) and 21.6% (number). An average content of deoxynivalenol for wheat amounted to 7.258 mg/kg and nivalenol to 5.267 mg/kg. In total, it was 12.788 m/kg of type B trichothecenes. The zearalenone content in the grain was 0.805 mg/kg. Relationships between FHB index, FDK and mycotoxin contents were statistically significant for triticale lines; however, they were stronger for FDK versus mycotoxins. Lines combing all types of FHB resistance were found, and two of them had resistance similar to that of wheat lines with the Fhb1 gene.

This paper examines the spatial and temporal distribution of all COVID-19 cases from January to June 2020 against the underlying distribution of population in the United States. It is found that, as time passes, COVID-19 cases become a power law with cut-off, resembling the underlying spatial distribution of populations. The power law implies that many states and counties have a low number of cases, while only a few highly populated states and counties have a high number of cases. To further differentiate patterns between the underlying populations and COVID-19 cases, we derived their inherent hierarchy characterized by the ht-index. We found that the ht-index of COVID-19 cases persistently approaches that of the populations; that is, 5 and 7 at the state and county levels, respectively. Mapping the ht-index of COVID-19 cases against that of populations provides new insights into the development of the pandemic in the United States.

Conceived and developed by Christopher Alexander through his life’s work: The Nature of Order, wholeness is defined as a mathematical structure of physical space in our surroundings. Yet, there was no mathematics, as Alexander admitted then, that was powerful enough to capture his notion of wholeness. Recently, a mathematical model of wholeness, together with its topological representation, has been developed that is capable of addressing not only why a space is good, but also how much goodness the space has. This paper develops a structural perspective on goodness of space – both large- and small-scale – in order to bridge two basic concepts of space and place through the very concept of wholeness. The wholeness provides a de facto recursive definition of goodness of space from a holistic and organic point of view. A space is good, genuinely and objectively, if its adjacent spaces are good, the larger space to which it belongs is good, and what is contained in the space is also good. Eventually, goodness of space – sustainability of space – is considered a matter of fact rather than of opinion under the new view of space: space is neither lifeless nor neutral, but a living structure capable of being more living or less living, or more sustainable or less sustainable. Under the new view of space, geography or architecture will become part of complexity science, not only for understanding complexity, but also for making and remaking complex or living structures.

Authorities define cities – or human settlements in general – through imposing top-down rules in terms of whether buildings belong to cities. Emerging geospatial big data makes it possible to define cities from the bottom up, i.e., buildings determine themselves whether they belong to a city based on the notion of natural cities that is defined based on head/tail breaks, a classification and visualization tool for data with a heavy-tailed distribution. In this paper, we used 125 million building locations – all building footprints of America (mainland) or their centroids more precisely – to derive 2.1 million natural cities in the country (http://lifegis.hig.se/uscities/). These natural cities – in contrast to government defined city boundaries – constitute a valuable data source for city-related research.

To improve the effect of multi-point stretch forming of sheet metal, it is proposed in this paper to replace fixed ball head with swinging ball head. According to the multi-point dies with different arrangements, this research establishes the finite element models of the following stretch forming, i.e. fixed ball heads with conventional arrangement, swinging ball heads with conventional arrangement, swinging ball heads with declining staggered arrangement, and swinging ball heads with parallel staggered arrangement and then numerical simulation is performed. The simulation results show that by replacing fixed ball head with swinging ball head, the surface indentation of the formed part was effectively suppressed, the stress and tension strain distribution of the formed part was improved and the forming quality was improved; that the thickness of the elastic pad was reduced, the springback was reduced and the forming accuracy was improved; and that when the ball head was applied to multi-point die with staggered arrangement, better forming result was achieved, where the best forming result was achieved in combining the swinging ball heads with the multi-point die with parallel staggered arrangement. The forming experiments were carried out, and the experimental results were consistent with the trend of numerical simulation results, which verified the correctness of the numerical simulation.

Purpose: The aim of present study was to compare the treatment results of daily cisplatin (CDDP), weekly docetaxel (DOC) intra-arterial infusion chemotherapy combined with radiotherapy (DIACRT) regimen and weekly CDDP intra-arterial infusion chemotherapy combined with radiotherapy (WIACRT) for patients with tongue cancer. Materials and Methods: Between January 2007 and December 2016, a total of 11 patients treated with WIACRT and 45 patients treated with DIACRT were enrolled in present study. In DIACRT group, 25 patients had T2, 20 patients had T3. A total of 9 patients had T2 and 2 had T3 in WIACRT (p = NS). In DIACRT, the treatment schedule consisted of intra-arterial chemotherapy (DOC, total 60 mg/m²; CDDP, total 150 mg/m²) and daily concurrent radiotherapy (RT) (total, 60 Gy). In WIACRT, the treatment schedule consisted of intra-arterial chemotherapy (CDDP, total 360 mg/m²) and daily concurrent RT (total, 60 Gy). Results: The median follow-up periods for DIACRT and WIACRT were 61 and 66 months respectively. The 5-year local control (LC) and overall survival (OS) rate were 94.5% and 89.6% for DIACRT group, 60.6% and 63.6% for WIACRT group respectively. The LC rate and OS of DIACRT group were significantly higher than that of WIACRT group. As regards toxicities, no treatment-related deaths were observed during the follow-up periods both in two groups. Conclusions: DIACRT was found to be feasible and effective for patients with tongue cancer and could become a new treatment modality.

This work focuses on the design improvement of a tri-axial piezoresistive accelerometer specifically designed for head injuries monitoring where medium-G impacts are common, for example in sports such as racing cars or American Football. The device requires the highest sensitivity achievable with a single proof mass approach, and a very low error (<1%) as the accuracy for these types of applications is paramount. The optimization method differs from previous work as it is based on the progressive increment of the sensor mass moment of inertia (MMI) in all three axes. The work numerically demonstrates that an increment of MMI determines an increment of device sensitivity with a simultaneous reduction of cross-talk in the particular axis under study. The final device shows a sensitivity increase of about 80% in the Z-axis and a reduction of cross-talk of 18% respect to state-of-art sensors available in the literature. Sensor design, modelling and optimization are presented, concluding the work with results, discussion and conclusion.

As Heterogeneous Wireless Sensor Network (HWSN) fulfill the requirements of researchers in the design of real life application to resolve the issues of unattended problem. But, the main constraint face by researchers is energy source available with sensor nodes. To prolong the life of sensor nodes and hence HWSN, it is necessary to design energy efficient operational schemes. One of the most suitable routing scheme is clustering approach, which improves stability and hence enhances performance parameters of HWSN. A novel solution proposed in this article is to design energy efficient clustering protocol for HWSN, to enhance performance parameters by EECPEP-HWSN. Propose protocol is designed with three level nodes namely normal, advance and super node respectively. In clustering process, for selection of cluster head we consider three parameters available with sensor node at run time, i.e., initial energy, hop count and residual energy. This protocol enhance the energy efficiency of HWSN, it improves performance parameters in the form of enhance energy remain in the network, force to enhance stability period, prolong lifetime and hence higher throughput. It is been found that proposed protocol outperforms than LEACH, DEEC and SEP with about 188, 150 and 141 percent respectively.

Taxanes, particularly docetaxel (DTX), has been widely used for combination therapy of head and neck squamous cell carcinoma (HNSCC). For locally advanced unresectable HNSCC, DTX combined with cisplatin and 5-fluorouracil as a revolutionary treatment revealed an advantage in improvement of patient outcome. In addition. DTX plus immune check inhibitors (ICIs) showed low toxicity and increased response of patients with recurrent or metastatic HNSCC (R/M HNSCC). Accumulating data indicate that taxanes not only function as antimitotics but also impair diverse oncogenic signalings including angiogenesis, inflammatory response, ROS production, and apoptosis induction. However, despite an initial response, development of resistance remains a major obstacle to treatment response. Taxane resistance could result from intrinsic mechanisms such as enhanced DNA/RNA damage repair, increased drug efflux, and apoptosis inhibition, and extrinsic effects such as angiogenesis and interactions between tumor cells and immune cells. This review provides an overview of taxanes therapy applied in different stages of HNSCC and describe the mechanisms of taxane resistance in HNSCC. Through a detailed understanding the mechanisms of resistance may help developing the potential therapeutic methods and the effective combination strategies to overcome drug resistance.

This study aimed to investigate the influence of cranio-cervical position on the electromyographical activity of the core muscles during the prone plank exercise. Twenty healthy participants were enrolled in this study. Muscle activation was registered using surface electromyography (sEMG) in the rectus abdominis (RA), external oblique (EO), internal oblique (IO) and lumbar portion of erector spinae (LES). Three prone plank conditions were randomly evaluated, varying the position of the cranio-cervical segment during the prone plank performance (NEUTRAL, FLEXION and EXTENSION). sEMG signals of each individual muscle, Total Intensity (TI) and ratings of perceived exertion (RPE) were analysed with statistical significance set at P&lt;0.05. FLEXION revealed significantly higher TI values compared to NEUTRAL and EXTENSION (p = 0.000; effect size (ES) &gt; 0.90). The RA presented larger activation in FLEXION compared to the other variations (p &lt; 0.05; ES &gt;0.70). FLEXION elicited a greater response compared to NEUTRAL for both sides of EO when compared to EXTENSION, and also for both sides of IO compared to the other conditions. Both FLEXION and EXTENSION reported higher RPE values compared to NEUTRAL. Cranio-cervical segment position influenced the electromyographical activation of core musculature, showing highest values when performing prone plank in a cranio-cervical flexion.

Head and neck squamous cell carcinoma (HNSCC) takes the sixth place among the most common cancers in the world. Abnormal methylation can be one of the reasons for this cancer. The aim of this study was to investigate the DNA promotor methylation status of cancer-associated genes (ATM, APC, CDO1, RB1, TP53, WIF1) in patients with HNSCC. Bisulfite Conversion and Methylation-Sensitive High-Resolution Melting was used for analysis of the DNA methylation level of normal and tumor tissues in 44 patients. There were significant differences in DNA methylation level between patient’s tumor and normal tissues for CDO1 and WIF1 genes in all subjects and subgroups (p<0.05). In T3 subgroup there was significant correlation between CDO1 gene methylation and age in the normal tissue. The same correlation was detected also for the WIF1 gene methylation in tumor tissue samples in the subgroup with T3 and in normal tissue samples in the subgroup with T4 (p<0,05). In all genes no significant differences were found between the subgroups (T2, T3, T4 stage, primary/recurrent lesion, non-keratinizing/keratinizing SCC, age before/ after 50, smokers/non-smokers) of the patients. Thus, changes in the expression of the CDO1 and WIF1 genes can affect mechanisms of the occurrence and development of HNSCC.

Introduction: The identification of some prognostic markers in head and neck cancers (HNC) is necessary for the stratification of the therapeutic approach with benefits in increasing treatment response rates and limiting the toxic side effects of treatments. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and pallets-to-lymphocyte ratio (PLR) are currently validated as cheap and accessible biomarkers in different types of solid tumors. The purpose of the study was to evaluate the possible biomarker value of NLR, PLR and MLR recorded pre-treatment (radiotherapy/chemotherapy) for prognostic purposes in HNC. Materials and methods: The study included 190 patients with HNC included in the oncology record in the oncology outpatient clinic of the Craiova County Emergency Hospital starting from January 2002 and deceased until December 2022. Among them, 40 patients treated multimodally in the Clinic were included in the study of Oncology of the Craiova County Emergency Hospital for which the pre-treatment value (chemotherapy/radiotherapy) of NLR, PLR and MLR could be calculated. Overall survival (OS) values were correlated with NLR, PLR and MLR. Results: Median values for NLR, PLR and MLR were 6.15 (1.24-69), 200.79 (61.3- 1775.0) and 0.53 (0.12-5.5) respectively. In the study, the mean values for NLR, PLR and MLR of 2.88, 142.97 and 0.36 respectively were obtained. Median OS in the study group was 11 months (1-120). Although a negative Pearson`s correlation, the relationship between your variables was only weak, values R =.07, p=.67; R=.02, p=.31 and R=07, p=.62 being related with NLR, PLR and MLR respectively correlation with overall survival (OS). The median values of NLR, PLR and MLR were calculated (1.53, 90.32 and 0.18 respectively) for HNC cases with pre-treatment values of NLR <2 and for HNC cases with NLR values ≥6 (23.5, 232.78 and 0.79 respectively). Median OS for cases with NLR<2 and NLR≥6 were 17.4 and 13 months, respectively. Conclusions: The negative correlations of NLR, PLR and MLR with OS reported in the study are in accordance with the data reported in the literature for locally advanced recurrent and metastatic HNSCC cases. The comparative analysis of the data in the group with NLR<2 and NLR≥6 highlights an advantage of 4.4 months in median OS in favor of the group with low values of NLR. Being cheap and accessible, these markers could change the therapeutic approach even in centers with limited resources. The role of borderline NLR values as a prognostic factor in HNSCC must also be defined. PLR and MLR are less evaluated as biomarkers but the study demonstrates their potential to be used as prognostic biomarkers, it remains to be clarified if their inclusion in multivariable models along with NLR would bring a benefit

Head and neck squamous cell carcinoma (HNSCC) is a type of cancer that arises from the epithelium lining of the oral cavity, hypopharynx, oropharynx, and larynx. Despite advancement of the current treatment to HNSCC, such as surgery, chemotherapy, and radiotherapy, the overall survival rate of HNSCC remains poor due to late diagnosis and acquired resistance to treatment. Natural products have been extensively explored as a safer and more acceptable alternative to current treatments, with numerous studies displaying their potential against HNSCC. This review highlights preclinical studies in the past 5 years involving natural products against HNSCC and explores the signalling pathways altered by these products. This review also addresses challenges and future directions of the use of natural products as chemotherapeutic and chemoprevention agents against HNSCC.

.Purpose: This paper presents a comparative analysis of state-of-the-art DIR algorithms in the context of head and neck squamous cell carcinoma (HNSCC) radiation therapy. Materials and Methods: We used a dataset of head and neck cancer patients within the Cancer Image Archive, which includes 31 patients with 3D CT image data from pre-treatment, mid-treatment, and post-treatment stages of radiotherapy. We applied DIR algorithms to two datasets, one for pre-treatment to mid-treatment registration and another for mid-treatment to post-treatment registration, by aligning one CT image to another CT image. To quantitatively analyze the patient data, we focused on the spinal cord, optic nerve, brain stem, cochlea, and PTV as the OAR datasets. To verify the DIR algorithm, we used two non-learning-based methods, SyN and NiftyReg, as well as three deep learning-based methods, Voxelmorph, Cyclemorph, and Transmorph. We trained a deep learning model by adjusting the ratio of the training dataset, validation dataset, and test dataset to 7:1:2. Results: The average DSCs of SyN and NiftyReg, the non-learning-based methods, were 0.74±0.06 and 0.70±0.12, respectively. The deep learning-based methods, Voxelmorph, Cyclemorph, and Transmorph, had average DSCs of 0.72±0.08, 0.68±0.11, and 0.69±0.13, respectively. The deep learning DIR algorithm produced transformed outputs of OAR/PTV in a shorter time than other models, including commercial and conventional mathematical algorithms (At Inference(sec/images), Voxelmorph: 0.36, Cyclemorph: 0.3, Transmorph: 5.1, SyN: 140, NiftyReg: 40.2). Conclusions: In conclusion, our study provides a comprehensive comparison of commercial DIR algorithms with traditional and deep learning-based DIR methods. Our results demonstrate that commercial DIR algorithms outperform traditional DIR methods in terms of accuracy and efficiency. However, we also show that deep learning-based DIR methods have the potential to achieve similar performance to commercial algorithms with proper training and optimization. Our findings suggest that both commercial and deep learning-based DIR methods have their respective advantages and limitations, and the choice of method should depend on the specific requirements of the clinical application. Overall, our study contributes to ongoing efforts to improve the accuracy and efficiency of DIR methods for better patient outcomes.

This paper aimed to describe an atlas of the head of the crested porcupine (Hystrix cristata), applying advanced imaging techniques such as MRI. Furthermore, by combining the images acquired through these techniques with anatomical gross sections, we obtained an adequate description of the structures that form the CNS and associated structures of this species. This anatomical information could serve as a valuable diagnostic tool for the clinical evaluation of different pathological processes in porcupines such as abscesses, skull malformations, fractures, and neoplasia.

In this paper, the sequential prime numbers are used as variables for the galactic spiral equations which were developed from the ROTASE model. Special spiral patterns are produced when prime numbers are treated with the unit of radian. The special spiral patterns produced with the first 1000 prime numbers have 20 spirals arranged in two groups. The two groups have perfect central symmetry with each other and are separated with two spiral gaps. The special spiral pattern produced with natural numbers from 1 to 7919 shows 6 spirals in the central area and 44 spirals in the outer area. The whole 7919 spiral points can be plotted with either 6-spiral pattern or 44-spiral pattern. For the spirals only produced by the prime numbers in the 6-spiral pattern plotting, the spiral 2 and spiral 3 each has only one spiral point produced by prime number 2 and 3, respectively, all other spiral points produced by other prime numbers are located on the spiral 1 and spiral 5. The special spiral pattern is well explained with careful analysis, it is concluded that all prime numbers greater than 3 must meet one of the equations: P₁ = 1 + 6 * n (n > 0) P₅ = 5 + 6 * n (n ≥ 0) In other words, every prime number greater than 3 is either a P₁ prime number or a P₅ prime number, no exception. Matching one of the equations is a necessary condition for a number to be a prime number, not a sufficient condition. Hope such sufficient condition can be found in the future. The number of P₁ prime numbers roughly equal the number of P₅ prime number in the first 2 billion prime numbers. The galactic spiral equations with golden angle can duplicate Vogel’s result for the simulation of sunflower seed head pattern, and a pinwheel pattern can be produced also with galactic spiral equations and 1 degree more than golden angle.

Objective: To investigate postacute laryngeal injuries and dysfunctions (PLID) in coronavirus disease 2019 (COVID-19) patients. Methods: Three independent investigators performed a systematic review of the current literature studying PLID in patients with a history of COVID-19. The review was performed according to PRISMA Statement. Epidemiological, clinical, hospitalization features, laryngeal diseases and voice outcomes were extracted from the included papers. Results: Eight papers met our inclusion criteria (393 patients) corresponding to 5 uncontrolled prospective and 3 retrospective studies. The most prevalent PLID were vocal fold dysmotility (65%), vocal fold edema (35%), laryngopharyngeal reflux (21%), and muscle tension dysphonia (21%). Posterior glottic stenosis (12%), granuloma (14%), and posterior glottic diastasis (12%) were the most common injuries. Most patients with PLID were obese and had a history of intensive care unit hospitalization, and orotracheal intubation. The delay between the discharge and the laryngology office consultation ranged from 51 to 122 days. The mean duration of intubation ranged from 10 to 34 days. Seventy-eight (49%) intubated patients were in prone position. The proportion of patients requiring surgical treatment ranged from 39% to 70% (mean=48%). There was an important heterogeneity between studies about inclusion, exclusion criteria and outcomes. Conclusion: COVID-19 appeared to be associated with PLID, especially in patients with a history of intubation. However, future controlled studies are needed to evaluate if intubated COVID-19 patients reported more frequently PLID than patients who were intubated for other conditions.

Understanding neck pain is an important societal issue. Kinematic data from sensors may help to gain insight on the pathophysiological mechanisms associated with neck pain through a quantitative sensorimotor assessment of one patient. The objective of this study was to evaluate the potential usefulness of artificial intelligence with several Machine Learning (ML) algorithms in assessing neck sensorimotor performance. Angular velocity and acceleration measured by an inertial sensor placed on the forehead during the DidRen laser test in thirty-eight acute and subacute non-specific neck pain (ANSP) patients were compared to forty-two healthy control participants (HCP). Seven supervised ML algorithms were chosen for the predictions. The most informative kinematic features were computed using Sequential Feature Selection methods. The best performing algorithm is the Linear Support Vector Machine with an accuracy of 82% and Area Under Curve of 84%. The best discriminative kinematic feature between ANSP patients and HCP is the first quartile of head pitch angular velocity. This study has shown that supervised ML algorithms could be used to classify ANSP patients and identify discriminatory kinematic features potentially useful for the clinicians in the assessment and monitoring of the neck sensorimotor performance in ANSP patients.

Otolith morphology analysis is one of the main tools used for fish or fish stock identification. Moreover, otolith shape can also be used in fish dietary studies (stomach content) for the identi-fication of prey fishes and their size according to the relationship between fish and otolith sizes. In the present study, the relationship between fish length and otolith morphological dimensions was investigated for the sabre squirrelfish, Sargocentron spiniferum (Forsskål, 1775) (family: Hol-ocentridae). Samples of 185 fish were collected from the coast of the Red Sea, Egypt. To analyze the relationship between fish and otolith, otolith morphometric measurements (length, width, area, perimeter, weight, sulcus, and ostium) and shape factors (aspect ratio, compactness, form factor, rectangularity, roundness, ellipticity, squareness) describing outline shape were extracted using image analysis. Generalized linear models were applied for the relationship between body length and each otolith morphology feature. From the relationships between the total length of fish and fourteen morphology features, only otolith length, caudal length, and squareness were significantly correlated with fish size. Our results provide more information for the relationship between fish length and otolith morphometric features.

Otolith morphology analysis is one of the main tools used for fish or fish stock identification. Moreover, otolith shape can also be used in fish dietary studies (stomach content) for the identification of prey fishes and their size according to the relationship between fish and otolith sizes. In the present study, the relationship between fish length and otolith morphological dimensions was investigated for the sabre squirrelfish, Sargocentron spiniferum (Forsskål, 1775) (family: Holocentridae). Samples of 185 fish were collected from the coast of the Red Sea, Egypt. To analyze the relationship between fish and otolith, otolith morphometric measurements (length, width, area, perimeter, weight, sulcus, and ostium) and shape factors (aspect ratio, compactness, form factor, rectangularity, roundness, ellipticity, squareness) describing outline shape were extracted using image analysis. Generalized linear models were applied for the relationship between body length and each otolith morphology feature. From the relationships between the total length of fish and fourteen morphology features, only otolith length, caudal length, and squareness were significantly correlated with fish size. Our results provide more information for the relationship between fish length and otolith morphometric features.

The problem of drug resistance in terms of antifungal therapy, unknown until a few years ago, is assuming increasing importance. Particularly in immunosuppressed patients and subject to chemotherapy and radiotherapy. In the last years the use of essential oils as approach to improving the effectiveness of antifungal agents and reducing the antibiotic resistant has been proposed. Our research aimed to evaluate the antifungal activity of Colombian essential oil of Ruta graveolens (REO) against clinical strains of Candida albicans, Candida parapsilopsis, C. glabrata and Candida tropicalis. The data obtained showed that Candida tropicalis and Candida albicans were most sensible strains showing minimum inhibitory concentrations (MIC) of 0.5 and 1.0 µg/ml of REO. The Time Kill Kinetics assay demonstrated that REO showed fungicide effect against C. tropicalis and fungistatic effect against C. albicans. In addition, the 40% of the biofilm formed by C. albicans was eradicated using 1% of REO after 1 hour of exposure.

Pediculus humanus capitis, the head louse, is an obligate blood-sucking ectoparasite that occurs in six divergent mitochondrial haplogroups (A, D, B, F, C and E), each exhibiting a particular geographic distribution. A few years ago, several studies reported the presence of different pathogenic agents in head lice specimens from different clades collected worldwide. These findings suggest that head louse could be a vector for dangerous diseases and therefore a serious public health problem. Herein, we aimed to study the mitochondrial genetic diversity, the PHUM540560 gene polymorphisms profile of head lice collected in Guinea, as well as to screen for the pathogens present in these lice. In 2018, a total of 155 head lice were collected from 49 individuals at the Medicals Centers of rural (Maférinyah village) and urban (Kindia city) areas, in Guinea. All head lice were subjected to genetic analysis and screened for the presence of several pathogens using molecular tools. The results showed that all head lice belonged to the haplogroups C/E using the duplex qPCR which detects both clades. Standard PCR and sequencing revealed that all specimens belonged to the haplogroup E, including 8 haplotypes, whither 6 new identified for the first time in this study. The study of the PHUM540560 gene polymorphisms in our Guinean head lice revealed that 7/40 (17.5%) of our tested samples exhibit three different polymorphism profiles compared to the clade A-head lice PHUM540560 gene profile, while the remaining specimens 33/40 (82,5%) showed the same PHUM540560 gene polymorphism profile as the previously reported clade A-body lice. Molecular investigations of the targeted pathogens revealed only the presence of Acinetobacter species in 9% of our samples using real time PCR. Sequencing results identified highlighted the presence of several Acinetobacter species, including Acinetobacter baumannii (14.3%), Acinetobacter nosocomialis (14.3%), Acinetobacter variabilis (14.3%), Acinetobacter haemolyticus (7.2%), Acinetobacter towneri (7.2%). Furthermore, a candidate new species of Acinetobacter sp. (7.2%) was detected. Positive specimens were collected from 24,5% individuals in Maférinyah. We also investigated in our study the carbapenem’s-resistant profile of A. baumannii, none of our specimens were positive for the following resistance genes blaOXA-21, blaOXA-24 and blaOXA-58. To the best of our knowledge, our study is the first to report the existence of the Guinean haplogroup E, the PHUM540560 gene polymorphism profile as well as the presence of Acinetobacter species in head lice collected from Guinea.

Fanconi anemia (FA) patients have an exacerbated risk of head and neck squamous cell carcinoma (HNSCC). Treatment is challenging as FA patients display enhanced toxicity to standard treatments, including radio/chemotherapy. Therefore better therapies as well as new disease models are urgently needed. We have used CRISPR/Cas9 editing tools in order to interrupt the human FANCA gene by the generation of insertions/deletions (indels) in exon 4 in two cancer cell lines from sporadic HNSCC having no mutation in FA-genes: CAL27 and CAL33 cells. Our approach allowed efficient editing, subsequent purification of single-cell clones, and Sanger sequencing validation at the edited locus. Clones having frameshift indels in homozygosis did not express FANCA protein and were selected for further analysis. When compared with parental CAL27 and CAL33, FANCA-mutant cell clones displayed a FA-phenotype as they i) are highly sensitive to DNA interstrand crosslink (ICL) agents such as mitomycin C (MMC) or cisplatin, ii) do not monoubiquitinate FANCD2 upon MMC treatment and therefore iii) do not form FANCD2 nuclear foci, and iv) they display increased chromosome fragility and G2 arrest after diepoxybutane (DEB) treatment. These FANCA-mutant clones display similar growth rates as their parental cells. Interestingly, mutant cells acquire phenotypes associated with more aggressive disease, such as increased migration in wound healing assays. Therefore, CAL27 and CAL33 cells with FANCA mutations are phenocopies of FA-HNSCC cells.

A Mild traumatic brain injury (mTBI) or concussion has become a public health problem in the United State. Sports and recreational activities are major sources of concussions; with the most incidents connected to American football. Recently, many companies and research institutions have started studying concussions and introduced some means of protection and some alarming systems of strong jolts. The major detection and protection system currently available on the market is the electronic helmet (e-helmet) composed of measurement devices to record head impact acceleration. The most commonly used devices in e-helmets are accelerometers to measure linear acceleration and gyroscopes for rotational/angular acceleration. Using smart textiles for concussion detection is currently uncommon and limited due to the lack of literature studying their voltage related errors. Actually, there are few works that characterize some voltage-force related errors for such type of sensors but for small impact forces and under bench testing while the behavior of those sensors was not described for higher ranges of applied forces and in field situations. This paper previews some common techniques used in e-helmets for concussion detection and highlights electronic textiles and smart fabric sensors that could be very useful for these applications. It discusses and validates the general behavior of such type of sensors under high impact forces and on field testing instead of bench testing, and also it characterizes the effect of increasing the thickness of the sensing element layer on the sensor. A custom-made pressure sensor was created of some available fabrics to be embedded within the padding of a football helmet to quantify the impacting force to the head. The sensor is mainly composed a Semi Conductive Polymer Composite SCPC layer with modifiable thickness that was modified three times with 0.2, 0.4, and 1.6mm to characterize the general behavior of the sensor due to a high amount of impacts and correlated with the thickness. A pendulum system was built to test the pressure sensors, while a special camera and an open-source video analysis software, Tracker was used to track the pendulum bob. The speed and the acceleration of the pendulum bob were measured, then the impact force was calculated and a voltage-force response was obtained. The results showed that no meaningful improvement occurs by small increase in the thickness but better sensor behavior could be obtained by significant increment to observe any difference. Despite that at a very high impacts, the suggested sensor with Velostat layers is not giving the real voltage readings that reflect the actual applied forces but it gives a helpful information that illustrate the distribution of the force through identification the place of the highest and lowest voltage readings regardless of the exact values of those readings. However, the proposed smart textile pressure sensor could be applicable in future e-helmet designs with additional research-based improvements especially on the structure of the sensing element layer to be able to withstand such high impacts which in turns improves the overall sensor performance and accurately measures pressure in concussion-inducing ranges.

Patient derived model systems are important tools for studying novel anti-cancer therapies. Patient derived xenografts (PDXs) have gained favor over the last 10 years as newer mouse strains have improved the success rate of establishing PDXs from patient biopsies. PDXs can be engrafted from head and neck cancer (HNC) samples across a wide range of cancer stages, retain the genetic features of their human source, and can be treated with both chemotherapy and radiation, allowing for clinically relevant studies. Not only do PDXs allow for study of patient tissues in an in vivo model, they can also provide a renewable source of cancer cells for organoid cultures. Herein, we review the uses of HNC patient derived models for radiation research including approaches to establishing both orthotopic and heterotopic PDXs, approaches and potential pitfalls to delivering chemotherapy and radiation to these animal models, biological advantages and limitations, and alternatives to animal studies that still use patient-derived tissues.

Currently, data regarding optimal treatment modality, response, and outcome specifically for N3 head and neck cancer are lacking. This study aimed to compare the treatment outcomes between definitive concurrent chemoradiotherapy (CCRT) to the neck and upfront neck dissection followed by adjuvant CCRT. 93 N3 squamous cell carcinoma head and neck cancer patients were included. Primary tumor treatment was divided to definitive CCRT (CCRT group) or curative surgery followed by adjuvant CCRT (surgery group). Neck treatment was also classified into two treatment modalities: definitive CCRT to the neck (CCRT group) or curative neck dissection followed by adjuvant CCRT (neck dissection group). Overall, the 2-year overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) were 51.8%, 47.3%, 45.6%, and 43.6%, respectively. In both oropharyngeal cancer and nonoropharyngeal cancer patients, in terms of OS, LRFS, RRFS or DMFS no difference was noted regarding primary tumor treatment (CCRT vs. surgery) or neck treatment (CCRT vs. neck dissection). In summary, N3 neck patients treated with definitive CCRT can achieve similar outcomes to those treated with upfront neck dissection followed by adjuvant CCRT. Cautions should be made to avoid overtreatment for this group of patients.

EZH2 overexpression is associated with tumor proliferation, metastasis, and poor prognosis. Targeting and inhibiting EZH2 may be an effective therapeutic strategy for head and neck squamous cell carcinoma (HNSCC). We previously analyzed EZH2 mRNA expression in a well-characterized dataset of 230 (110 original and 120 validation cohorts) human head and neck cancer samples. This study aimed to investigate the effects of inhibiting EZH2, either via RNA interference or via pharmacotherapy, on HNSCC growth. EZH2 upregulation was significantly correlated with recurrence (P < 0.001) and the methylation index of tumor suppressor genes (P < 0.05). DNMT3A was significantly upregulated upon EZH2 upregulation (P = 0.043). Univariate analysis revealed that EZH2 upregulation was associated with poor disease-free survival (log-rank test, P < 0.001). In multivariate analysis, EZH2 upregulation was evaluated as a significant independent prognostic factor of disease-free survival (hazard ratio: 2.085, 95% confidence interval: 1.390–3.127; P < 0.001). Cells treated with RNA interference and DZNep, an EZH2 inhibitor, showed the most dramatic changes in expression, accompanied with a reduction in the growth and survival of FaDu cells. These findings suggest that EZH2 upregulation is correlated with tumor aggressiveness and adverse patient outcomes in HNSCC. Evaluation of EZH2 expression might help predict the prognosis of HNSCC patients.

In small-scale hydropower scheme, the most important component is electro-mechanical equipment. Since cost contribution of this component is high because hydrokinetic projects require negligible civil works. Turbine and alternator contribute major fraction of the hydrokinetic projects. Thus, there is a requirement to estimates the electromechanical equipment cost for the hydrokinetic hydropower scheme. The present paper investigates design parameters of the hydrokinetic turbines and intends to develop cost correlation which depends on most critical parameters of hydropower sites such as velocity and power capacity. In this present work, three zero head turbines are considered including straight blade Darrieus, two Stage Savonius, and Gorlov Helical. The size and cost of major components have been calculated based on material, manufacturing, research and design, and assembly costs. Based on cost and site parameters, cost correlation has been developed. The obtained cost has been validated with available zero head turbines in the market and installed projects. A techno-economic analysis has been carried out to select economical hydrokinetic turbine for river and canal application.

(1) Background: P-cadherin (CDH3) is a transmembrane protein that plays a crucial role in maintaining the structural integrity of epithelial tissue and homeostasis. Its role in carcinogenesis remains a subject of debate, as its behavior can vary depending on the molecular context and the specific tumor cell model under study. In this study, we explored the role of P-cadherin in head and neck squamous cell carcinoma (HNSCC) and the mechanism underlying its function. (2) Methods: We analyzed P-cadherin expression in HNSCC patients using The Cancer Genome Atlas (TCGA) database. For in vitro functional analysis, we conducted proliferation, migration, invasion, and western blot assays after either suppressing or overexpressing P-cadherin. For in vivo functional analysis, we utilized mouse xenograft models. (3) Results: P-cadherin was significantly overex-pressed in tumor samples compared to normal samples in the TCGA-HNSCC cohort. P-cadherin knockdown resulted in decreased proliferation, migration, and invasion compared to control cells, while P-cadherin overexpression increased cell proliferation and migration in HNSCC cells. We discovered that c-Met functioned as an upstream regulator of P-cadherin. Surprisingly, we found that P-cadherin knockdown increased the phosphorylation of c-Met and STAT3. Combining P-cadherin siRNA with the c-Met inhibitor SU11274 resulted in a more effective reduction in HNSCC cell growth, both in vitro and in vivo, compared to either treatment alone. (4) Conclusions: Our study uncovered a previously unknown aspect of P-cadherin-mediated c-Met regulation. The enhanced activation of c-Met/STAT3 following P-cadherin inhibition could be responsible for the survival of resistant tumor cells. Therefore, dual inhibition of P-cadherin and c-Met may be a potentially effective approach for treating HNSCC.

Introduction and objectives Obstructive sleep apnea (OSA) is defined as a cause of daytime sleepiness, as well as a clinical manifestation of sleep-disordered breathing. In the literature, there are numerous controversial studies regarding the etiology of this condition, but it is universally accepted that a significant role in its onset is played by the reduced activity of the upper airway muscles. Additionally, OSA has been associated with a series of comorbidities, such as type II diabetes, metabolic syndrome, cardiovascular and pulmonary conditions, as well as head and neck tumors, especially oropharyngeal and laryngeal tumors. The purpose of this review is to examine and demonstrate the prevalence of OSA in patients with associated pathologies, especially in patients with head and neck tumors, as well as the role of surgical and non-surgical therapeutic methods in improving the quality of life. Material and methods Taking into consideration the stated objective, a systematic analysis of the available literature was conducted, encompassing PubMed, Medline and Scopus databases. The evaluation was based on several keywords, including head and neck cancer, diabetes, diabetic, overlap syndrome, cardiovascular conditions, laryngeal neoplasm, radiotherapy, chemotherapy, as well as the concept of quality of life in laryngectomized patients and patients with OSA. Results Our results demonstrate the involvement of OSA in the presence of comorbidities and also, an increased incidence of OSA in patients with laryngeal cancer. It is important to note that surgical and post-surgical treatment can play a significant role in triggering OSA in these patients. Conclusions The clinician must recognize the increased prevalence of OSA in patients with head and neck cancer, as well as the coexistence of OSA with certain comorbidities. They should actively engage in early diagnosis and establish optimal treatment methods to improve the quality of life for patients with associated conditions such as head and neck tumors or cardiovascular pathology.

The metastatic disease is a complex and sequential process that involves the migration of tumor cells from the primary site to distant areas. This metastatic pathway is not always predictable. Therefore, this paper presents three rare cases of unusual metastases, due to their primary site: two metastases of a clear cell renal cell carcinoma, one gingival and one nasal, as well as a mandibular metastasis of a hepatocellular carcinoma. In all cases, an incisional biopsy was performed in order to sign out the diagnosis. After microscopical examination of morphological Hematoxylin and Eosin stained slides, for all cases, immunohistochemical reactions were performed to support the primary tumor site. Two cases had a previous histopathological diagnosis of a primary tumor, while for the third case, the metastatic lesion represented the first manifestation of the neoplastic disease, with an unfavorable prognosis.

Using traditional methods based on detection rules written by human security experts, there is a significant challenge in accurately detecting many network threats that are increasingly becoming sophisticated. In order to deal with the limitation of the traditional methods, network threat detection techniques utilizing artificial intelligence technologies such as machine learning are being extensively studied. Research has also been conducted on analyzing various string patterns in network packet payloads through natural language processing techniques to detect attack intent. However, due to the nature of packet payloads containing binary data as well as text data, a new approach is needed that goes beyond typical natural language processing techniques. In this paper, we study a token extraction method optimized for payloads using n-gram and byte pair encoding techniques. Furthermore, we generate embedding vectors that can understand the context of the packet payload using algorithms such as Word2Vec and FastText. We also compute the embedding of various header data associated with packets, such as IP addresses and ports. Given the combination of these features, we ensemble a text 1D-CNN and a multi-head attention network in a novel fashion. We validated the effectiveness of our classification technique with the CICIDS2017 open dataset and over half a million data collected by The Education Cyber Security Center (ECSC) currently operating in South Korea. The proposed model showed remarkable progress compared to previous studies, demonstrating a highly accurate classification performance with an F1-Score of 0.998. Our model can also preprocess and classify 150,000 network threats per minute to help security agents in the field divert their time to analyzing more complex attack patterns.

Synthetic Aperture Radar (SAR) is an active sensor that uses microwave for sense, it is unrestricted by weather and illumination conditions, and it can observe targets all day and weather. Aircraft targets are important monitoring objects in military and civilian fields, and how to efficiently detect and recognize aircraft targets is an important topic in the field of SAR image interpretation. Based on the features of SAR images, such as complex background, high resolution, and multi-scale, we proposed an improved method based on YOLOv5s. Firstly, this paper proposed the structure of the multi-scale receptive field and channel attention fusion, which is applied to the shallow layer of the backbone of YOLOv5s, it can adjust the weights of the multi-scale receptive field during the training process to enhance the extraction ability of feature information. Secondly, we proposed four de-coupled detection heads to replace the original part in YOLOv5s, which can improve the efficiency and accuracy of SAR image interpretation for small targets. Thirdly, in the case of the limited amount of SAR images, this paper proposed multi methods of data augmentation, which can enhance the diversity and generalization of the network. Fourthly, this paper proposed the K-means++ to re-place the original K-means to improve the network convergence speed and detection accuracy. Finally, Experiments demonstrate that the improved YOLOv5s can enhance the accuracy of SAR image interpretation by 9.3%, and the accuracy of small targets is improved more obviously, reaching 13.1%.

The study of notable people as agents for increasing cancer awareness started just in the last decades of the 20th century. This study aimed to identify Pan-American notable people with head and neck cancer (HNC) and to assess HNC’s professional perspective on communicating stories of notable patients with HNC to promote prevention. Methods: This cross-sectional study was conducted by applying a RedCap questionnaire to oral medicinists, oral pathologists, head and neck surgeons, and clinical oncologists with experience in HNC research, education, or treatment in Pan-American countries. Additionally, a structured search was performed on PubMed, Scopus, EMBASE, Web of Science, LILACS, and gray literature Results: We identified 42 notable people from the United States, Brazil, Argentina, Mexico, El Salvador, Chile, Colombia, and Peru who were mainly actors, athletes, and musicians. Participants agreed that stories of notable patients with HNC can positively impact the population and promote prevention if communicated by the internet, social media, and television. Conclusion: In the Pan-American region, notable individuals who have suffered from HNC may be powerful advocates for increasing cancer awareness and promoting prevention strategies. The professionals involved in the study expressed a positive inclination towards using the stories of these notable HNC survivors as an effective prevention strategy.

Head and neck squamous cell carcinoma (HNSCC) arise from the mucosal epithelium in the oral cavity, pharynx, sino-nasal region, and larynx. Laryngeal squamous cell carcinoma (LSCC) represents one-third of all head and neck cancers. Dysregulated RNA-related pathways define an important molecular signature in this aggressive carcinoma. The Survival Motor Neuron (SMN) protein regulates fundamental aspects of the RNA metabolism but, curiously, its role in cancer is virtually unknown. For the first time, here we focus on SMN in cancer context. We conducted a pilot study in a total of 20 patients with LSCC where SMN was found overexpressed at both the protein and transcript levels. By a cellular model of human laryngeal carcinoma, we demonstrated that SMN impacts cancer-relevant behaviors and perturbs key players of cell migration, invasion, and adhesion. Furthermore, in LSCC we showed a physical interaction between SMN and the epidermal growth factor receptor (EGFR), whose overexpression is an important feature in these tumours. This study candidates SMN as novel therapeutic target in LSSC, and likely in the whole spectrum of HNSCC. Overall, we provide the first analysis of SMN in human cancer.

Fusarium head blight (FHB) is a wheat disease caused by fungi of the genus Fusarium. The aim of the study was to find relationships between the weather conditions in the experimental years and the locations and the amount of F. culmorum DNA and trichothecene genotypes, as well as the proportions between them. A three-year field experiment (2017, 2018 and 2019) was established at two locations (Poznań, Radzików). F. culmorum DNA was detected in all grain samples in an average amount of 20124 pg per 1 g of wheat DNA. The average amount of DNA from the 3ADON genotype was 4879 pg/μg and the amount of DNA from the NIV genotype was 3330 pg/μg. In the three experimental years, a large variability was observed in the coefficients of correlation between DNA concentrations and the FHB index, FDK, ergosterol, and the corresponding toxins. There were significant correlations between disease incidence, fungal biomass (quantified as the total amount of fungal DNA or DNA trichothecene genotypes) and toxins (DON, 3AcDON and NIV) concentrations. The 3ADON trichothecene genotype dominates over the NIV genotype (ratio 1.5); however, this varied greatly depending on environmental conditions.

Objective: The combination of docetaxel (DTX) with Laser-Activated NanoTherapy (LANT), as a treatment for head and neck cancer (HNC) may enhance the therapeutic efficacy of lower doses of DTX, thereby minimizing the effective dosage, side effects and treatment times. Material and methods: Three HNSCC cell lines, Detroit 562, FaDu, and CAL 27, were treated with four combinations of DTX + LANT to evaluate DTX dose reduction and cell viability. Results: The 1 nM DTX + 5 nM LANT combination was the most effective treatment, increasing cell death over its corresponding DTX monotreatment with approximately 86.6%, 80.7%, and 92.1% cell death for Detroit 562, FaDu, and CAL 27, respectively. In Detroit 562, the 1 nM DTX + 5 nM LANT combination treatment resulted in the highest percentage of DTX dose reduction at 84.6%; in FaDu and CAL 27, the 0.5 nM DTX + 5 nM LANT combination treatment resulted in the highest percentage of DTX dose reduction at 78.2% and 82.4%, respectively. Conclusion: LANT may increase the therapeutic efficacy of DTX at significantly lower doses, which could improve patient outcomes.

Head injury is among the most devastating types of injury, specifically called Traumatic Brain Injury (TBI). There is need to diminish the morbidity related with TBI and to improve the outcome of patients suffering TBI. Among the improvements on the treatment of TBI, neuroprotection is one of the upcoming improvements. Citicoline has been used in the management of brain ischemia related disorders, such as TBI. Citicoline has biochemical, pharmacological, and pharmacokinetic characteristics that make it a potentially useful neuroprotective drug for the management of TBI. A short review of these characteristics is included in this paper. Also, a narrative review of almost all the published or communicated studies performed with this drug in the management of patients with head injury is included. Based on the results obtained in these clinical studies, it is possible to conclude that citicoline was able to accelerate recovery of consciousness and to improve the outcome of this kind of patients, with an excellent safety profile. Thus, citicoline could have a potential role in the management of TBI.

Conformal radiotherapy is a primary treatment in head and neck cancer, which putative adverse effects depend on relatively low doses of radiation delivered to increased volumes of normal tissues. Systemic effects of such treatment include radiation-induced changes in serum lipid profile, yet dose- and volume-dependence of these changes remain to be established. Here we analyzed levels of choline-containing phospholipids in serum samples collected consecutively during the radiotherapy used as the only treatment modality. The LC-MS approach applied in the study enabled the detection and quantitation of 151 phospholipids, including (lyso)phosphatidylcholines and sphingomyelins. No statistically significant differences were found in the pre-treatment samples from patients with different location and stage of cancer. To compensate for potential differences between schemes of radiotherapy the biologically effective doses were calculated and used in the search of correlations with specific lipid levels. We found that the levels of several phospholipids depended on the maximum dose delivered to the gross tumor volume and total radiation energy absorbed by the patient’s body. Increased doses correlated with increased levels of sphingomyelins and reduced levels of phosphatidylcholines. Noteworthy, serum phospholipid levels were associated mainly with volumes of normal tissues irradiated with relatively low doses (i.e., total accumulated dose 20 Gy), which indicated the importance of such effects on the systemic response of the patient’s organism to IMRT.

Chemotherapy treatment based on Cisplatin (CDDP) is established as the drug of choice for head and neck squamous cell carcinoma (HNSCC). Malignant tumors respond to microenvironment alteration through a dynamic balance of mitochondrial fission and fusion. HNSCC is known to have hypoxic conditions, yet the effects and underlying mechanisms of hypoxia on chemosensitivity and mitochondrial dynamics remain unclear. We found that hypoxia promoted mitochondrial fission and CDDP sensitivity in HNSCC cells. Importantly, Mff was shown to be correlated with chemosensitivity in clinical samples of HNSCC that underwent a hypoxic condition. Hypoxia-inducible factor 1 α-subunit (HIF-1α) dramatically increased Mff transcriptional expression and directly bound to Mff. Hypoxia enhanced the release of reactive oxygen species (ROS) and upregulated the expression of Mff via HIF-1α in HNSCC cells. ROS depletion in HNSCC cells attenuated HIF-1α, Mff expression, and mitochondrial fission. Moreover, a knockdown of Mff suppressed hypoxia-induced mitochondrial fission and decreased CDDP chemosensitivity in vivo and in vitro. Our findings revealed that the hypoxia-induced release of ROS promoted mitochondrial fission and CDDP chemosensitivity via the regulation of HIF-1α/Mff in HNSCC cells, indicating that Mff may serve as a new biomarker to predict neoadjuvant chemosensitivity in HNSCC patients

The sensor nodes have limited computation, sensing, communication capabilities and generally operated by batteries in a harsh atmosphere with non-replenish able power sources. These limitations force the sensor network subject to failure because most of the energy is spent on sensing, computing and data transmission. This paper introduces an Energy Efficient Clustering and Shortest-Path Routing Protocol (EECSRP) to assist Wireless Sensor Networks (WSNs) by (a) extending the lifespan of the network (b) effectively using the battery power (c) decreasing the network overhead and (d) ensuring a high packet transmission ratio with minimal delay. The delay time-based Cluster Head (CH) is elected based on the node degree, residual energy and Received Signal Strength (RSS) to accomplish the goal. Additionally, the RSS-based network partitioning is implemented to evaluate the gradient based on demand routing between source (sensing node) and destination (BS). Whenever the current CH residual energy goes under the threshold level, the proposed protocol performs the clustering process, reducing the exchange of control packets. However, the BS periodically gathers the data from every single CH which helps to reduce the collision and Medium Access Control (MAC) layer conflict. From the simulation results, it is the evident that the proposed protocol performance in terms of average end-to-end latency, packet delivery ratio, average energy consumption and control overhead is better than the well-known current protocols.

The incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is rising in the West, but little is known in Asia. This study elucidated changes in the incidence and HPV-positive portion of OPSCC in Hong Kong. Data from population-based cancer registry were used to analyze the incidence of OPSCC in associate with other head and neck cancers. Archived tumour tissues were tested for HPV. From 1986 to 2020, there was a marked decrease in the incidence of nasopharyngeal and laryngeal cancers, but a persistent increase in OPSCC from 36 cases in 1986 to 116 cases in 2020. The average positive rate for high-risk HPV was 36.1% (112/310) among OPSCC diagnosed in 2010-2020. The HPV positive rate in recent years was significantly higher than earlier cases (tonsil SCC: 64.7% (55/85) in 2016-2020 vs. 40.4% (19/47) in 2010-2015, P = 0.007). Patients with HPV-positive tonsil cancers were significantly younger than those negative (mean [SD]: 58.9 [9.9] vs. 64.3 [13.3] years, P = 0.006), but no significant difference between genders. A persistent increase in the incidence of oropharyngeal cancer over the last few decades was observed in Hong Kong, which can be explained by the remarkable increase in HPV-positive tonsil cancers.

(1) Background: The goal of the study was to evaluate psychological tolerance and health-related quality of life (QOL) in head and neck (HN) cancer patients treated with definitive accelerated radiotherapy (DART); (2) Methods: Seventy-six recurrence-free patients eligible for the study, who were treated with DART in the CAIR-2 phase III clinical study (median of follow-up=47 months), completed EORTC QLQ-C30 with H&amp;N35 module, Hospital Anxiety and Depression Scale (HADS) and Visual–Analog Scales (VAS) of pain in HN and the neck / arm area.; (3) Results: The most dominating symptoms measured with QLQ-C30 were: fatigue (44/100), sleeplessness (39/100), financial problems (38/100) and pain (32/100). Within H&amp;N35 the highest scores were reported on the subscales of sticky saliva (60/100), mouth dryness (65/100) and increased intake of painkillers (50/100). Pain (VAS) was reported by 87% (HN area) and 78% (shoulder) of the patients, with a mean score of 3/10. One-third reported depressive mood (HADS≥15 points) with an average score of 12.5/42 p. The depressed group, who smoked more as compared to non-depressed before DART (96% vs 78%) and required steroids treatment (85% vs 58%) during DART, also scored significantly worse on 23 of 35 subscales of QLQ-C30 and H&amp;N35 and experienced more intense pain (VAS). Women, and less advanced patients scored better in several aspects of the quality of life; (4) Conclusions: Patients treated with DART struggle with low quality of life and persisting treatment-related symptoms including constant pain. HNC survivors, especially those, who are depressed, may require additional psychosocial, rehabilitation and medical intervention programs..

Upper limb paresis is very common after stroke. An important tool to assess motor recovery is to use marker-based motion capture systems to measure the kinematic characteristics of patients’ movements in ecological scenarios. These systems are, however, very expensive and, as such, not readily available for many rehabilitation units. Here, we explored whether the markerless hand motion capabilities of the cost-effective Oculus Quest head-mounted display could be used to provide clinically meaningful measures. 14 stroke patients executed ecologically relevant upper limb tasks in an immersive virtual environment. During task execution, we recorded their hand movements simultaneously by means of the Oculus Quest’s and a marker-based motion capture system. Our results showed that the markerless estimates of the hand position and peak velocity provided by the Oculus Quest were in very close agreement with those provided by a marker-based commercial system with their regression line having a slope close to 1. Furthermore, the Oculus Quest had virtually the same sensitivity as that of a commercial system in distinguishing healthy from pathological kinematic measures. The Oculus Quest was as accurate as a commercial marker-based system in measuring clinically meaningful upper limb kinematic parameters in stroke patients.

The root system plays an irreplaceable role in plant growth. Its improvement can increase crop productivity. However, such system is still mysterious for us. The underlying mechanism has not been fully uncovered. The investigation on proteins related to the root system is an important means to complete this task. In the previous time, lack of root-related proteins makes it impossible to adopt machine learning methods for designing efficient models for the discovery of novel root-related proteins. Recently, a public database on root-related proteins was set up and machine learning methods can be applied in this field. In this study, we proposed a machine learning based model, named Graph-Root, for identification of root-related proteins. The features derived from protein sequences and one network were extracted, where the former features were processed by graph convolutional neural network and multi-head attention, and the later features abstracted the linkage between proteins. These features were fed into the fully connected layer to make prediction. The 5-fold cross-validation and independent tests suggested its good performance. It also outperformed the only one previous model, SVM-Root. Furthermore, the importance of each feature type and component in the proposed model was investigated.

Introduction: Osteosarcomas of the jaw (OSJ) are rare tumors with a different behavior from osteosarcomas of other bones. This study aims to analyze the clinical, pathological, and therapeutic characteristics of this type of sarcoma. Methods: a retrospective observational study of cases diagnosed with OSJ registered at the “La Paz” University Hospital (Madrid). Results: Eight cases with a diagnosis of OSJ were obtained in a study period of 22 years (2000-2022). The mean age was 41 years. The distribution was 1:1 between the maxilla and mandible. Painful inflammation was the most frequent clinical manifestation. Conventional osteoblastic osteosarcoma was the most common. Survival at 5 years was 50%, while at 10 years, it decreased to 25%. Conclusions: OSJ differs from conventional osteosarcomas of long tubular bones. Surgery continues to be the mainstay of treatment; more studies are needed in which more standardized protocols can be proposed for adjuvant therapeutic management.

Radiomics involves the extraction of information from medical images not visible to the human eye. There is evidence these features can be used for treatment stratification and outcome prediction. However, there is much discussion about the reproducibility of results between different studies. This paper studies the reproducibility of CT texture features used in radiomics, comparing two feature extraction implementations namely Matlab toolkit and Pyradiomics when applied on independent datasets of CT scans of patients i) the open access RIDER dataset containing a set of repeat CT scans taken 15 minutes apart for 31 patients (RIDER Scan 1 and Scan 2 respectively) treated for lung cancer and ii) the open access HN1 dataset containing 137 patients treated for head and neck cancer. Gross tumor volume (GTV) manually outlined by an experienced observer available on both datasets was used. 43 common radiomics features available on Matlab and Pyradiomics were calculated using 2 intensity-level quantization methods with and without an intensity threshold. Cases were ranked for each feature for all combinations of quantization parameters and the Spearman’s rank coefficient, rs, calculated. Reproducibility was defined when a highly correlated feature in the RIDER dataset also correlated highly in the HN1 dataset and vice versa. 29 out of 43 reported stable features were found to be highly reproducible between Matlab and Pyradiomics implementations, having consistently high correlation in rank ordering for RIDER Scan 1 and RIDER Scan 2 (rs &gt; 0.8). 18/43 reported features were common in RIDER and HN1 datasets, suggesting they may be agnostic to disease site. Useful radiomics features should be selected based on reproducibility. This study identified a set of features that meet this requirement and validated the methodology for evaluating reproducibility between datasets.

Background: With the trend of intelligent display, the interface design of in-vehicle HUD is an expanding research field; Methods: To solve the subjectivity and uncertainty in the optimization of HUD interface design schemes, this paper proposed a hybrid scheme evaluation and optimization method based on entropy weight and VIKOR. The entropy weight method was used to reduce the subjectivity the decision-maker's weighting and obtain the objective weight of each indicator; The VIKOR method was used to obtain the best ranking of alternative schemes, and then the optimal interface design scheme was selected; Results: The evaluation of in-vehicle HUD interface design schemes were taken as an example for verification and calculation. The results showed that this method considers the subjectivity and uncertainty of the decision-making process in the optimization of design scheme, which can effectively improve the objectivity and accuracy of the evaluation results, and provide a reference for designers to optimize interface design schemes.

Background: In the present study, we assessed the feasibility and success outcomes of voice prosthesis (VP) changes when performed by speech-language pathologist (SLP). Methods: Patients treated with total laryngectomy (TL) from January 2020 to December 2020 were prospectively recruited from our medical center. Patients benefited from tracheoesophageal puncture. The VP changes were performed by the senior SLP and the following data were collected for each VP change: date of placement; change or removal; VP type and size; reason for change or removal; and use of a washer for periprosthetic leakage. A patient-reported outcome questionnaire including 6 items was proposed to patients at each VP change (Appendix 1). Items were assessed with a 10-point Likert-scale. Results: Fifty-two VP changes were performed by the senior SLP during the study period. The mean duration of the SLP consultation, including patient history, examination and VP change procedure was 20 min (range: 15-30). The median prosthesis lifetime was 88 days. The main reasons for VP changes were transprosthetic (N=34; 79%) and periprosthetic (N=7; 21%) leakages, respectively. SLP successfully performed all VP changes. He did not change one VP but used a periprosthetic silastic to stop the periprosthetic leakages. In two cases, SLP needed the surgeon examination to discuss about the following indication: implant mucosa inclusion and autologous fat injection. The patient satisfaction was high according to the speed and the quality of care by the SLP. Conclusion: The delegation of VP change from the otolaryngologist-head and neck sur-geon to the speech-language pathologist (SLP) may be done without significant complications. The delegation of VP change procedure to SLP may be interesting in some rural regions with otolaryngologist shortage.

β₂-m, β₂-microglobulin; CAF, cancer associated fibroblast; CSC, cancer stem cell; CTL, cytotoxic T lymphocyte; DC, dendritic cell; ECM, extracellular matrix; EGF-R, epidermal growth factor receptor; ER, endoplasmic reticulum; FDA, Food and Drug Administration; HLA, human leukocyte antigen; HNSCC, head and neck squamous cell carcinoma; HPV, human papilloma virus; ICP immune checkpoint; ICPi, immune checkpoint inhibitor; IFN, interferon; LMP, low molecular weight protein; mAb, monoclonal antibody; MDSC, myeloid-derived suppressor cell; mTOR, mammalian target of rapamycin; MSI, multispectral imaging; NK, natural killer; OS, overall survival; PBL, peripheral blood lymphocytes; PBMNC, peripheral blood mononuclear cells; PD1, programmed death receptor 1; PD-L1, programmed death ligand 1; PFS, progression-free survival; PI3K, phosphatidyl-linositol-3-kinase; R/M, recurrence and or metastatic; STAT, signal transducer and activator of transcription; TAA, tumor-associated antigen; TAM, tumor associated macrophages; TAP, transporter associated with antigen processing; TCR, T cell receptor; TIL, tumor-infiltrating lymphocyte; TLS, tertiary lymphoid structure; TME, tumor microenvironment; Treg, regulatory T cell; TSA, tumor-specific antigen; VEGF, vascular endothelial growth factor; VEGF-R, vascular endothelial growth factor receptor.

Aero-fuel centrifugal pumps are important power plants in aero-engines. Unlike most of the existing centrifugal pumps, a combination impeller is integrated with the pump to improve its performance. First, the critical geometrical parameters of combination impeller and volute are given. Then, the effects of combination impeller on flow characteristics inside the impeller and volute are clarified by comparing simulation results with that of the conventional impeller, where the effectiveness of selected numerical method is validated by an acceptable agreement between simulation and experiment. Finally, the experiment is performed to test the external performance of studied pump. A significant feature of this study is that the flow characteristics are significantly ameliorated by reducing the flow losses emerged in impeller inlet, impeller outlet and volute tongue. Correspondingly, the head and efficiency of combination impeller are higher with comparison to conventional impeller. Consequently, it is a promising approach in ameliorating flow field and improving external performance by applying a combination impeller to an aero-fuel centrifugal pump.

Background and objectives: Induction chemotherapy (ICT) before definitive chemoradiation (CRT) gives high response rates in LA-SCCHN. However, pre-ICT gross tumour volume (GTV) for radiotherapy (RT) planning is still recommended. As ¹⁸F-FDG PET/CT has an advantage of biological tumour information comparing to standard imaging methods, we aimed to evaluate the feasibility of ¹⁸F-FDG PET/CT-based post-ICT GTV delineation for RT planning in LA-SCCHN and to assess the prognostic value of PET parameters: maximum standardized uptake value (SUV_max), metabolic tumour volume (MTV) and total lesion glycolysis (TLG). Methods: 47 LA-SCCHN patients were treated with 3 cycles of ICT (docetaxel, cisplatin, and 5-fluorouracil) followed by CRT (70 Gy in 35 fractions with weekly cisplatin). Pre- and post-ICT PET/CT examinations were acquired. Planning CT was co-registered with post-ICT PET/CT and RT target volumes were contoured according to post-ICT PET. Post-ICT percentage decrease of SUV_max, MTV and TLG in primary tumour and metastatic regional lymphnodes (LN) was counted. Loco-regional failure patterns, 3-year progression free (PFS) and overall survival (OS) were evaluated. Results: 3-year PFS and OS rates for study population were 67% and 61% respectively. 31.9% of patients progressed loco-regionally. All progresses were localised in high-to-intermediate dose (60–70 Gy) RT volumes and none in low dose (50 Gy) volumes. Decrease of SUV_max ≥74% (p = 0.03), MTV ≥ 68% (p = 0.04), TLG ≥ 76% (p = 0.02) in primary tumour, and LN TLG decrease ≥74% (p = 0.03) were associated with PFS. Decrease of primary tumour SUV_max ≥ 74% (p = 0.04), MTV ≥ 69% (p = 0.04), TLG ≥ 74% (p = 0.02) and LN TLG ≥ 73% (p = 0.02) were prognostic factors for OS. Conclusions: According to our results, 18F-FDG PET/CT-based post-ICT GTV delineation is feasible strategy without negative impact on loco-regional control and survival. Percentage decrease of metabolic PET parameters SUV_max, MTV and TLG has a prognostic value in LA-SCCHN.

A simple and rapid method for the extraction of D-series resolvins (RvD1, RvD2, RvD3, RvD4, RvD5) released into Leibovitz's L-15 complete medium by head kidney cells from Atlantic salmon and further liquid chromatography triple quadrupole mass spectrometry determination is proposed. A three-level factorial design was proposed to select the optimal concentrations of internal standards that were used in the evaluation of the performance parameters such as linear range (0.1-50 ng/mL), limits of detection and quantification (0.05 and 0.1 ng/mL, respectively) and recovery values (98.99±0.00). The optimized method was used to determine the stimulated production of resolvins by head kidney cells exposed to docosahexaenoic acid, and the results indicated that it is possible that the production was controlled by circadian responses.

Objective: To describe technique of platelet rich plasma injection into the olfactory cleft in patients with long-term COVID-19 olfactory dysfunction. Methods: The technique starts with the blood extraction and the isolation of PRP through a 10-min centrifugation (4,200 rpm). The supernatant was injected in nasal regions with a 27-G needle after a local anesthesia with Xylocain 10% spray. The injection was performed through a 0° rigid optic. Precisely, several points of 0.2–0.5 mL were performed in the nasal septum in regard of the head of the middle turbine, and in the head of the middle turbine in both sides. Clinical, psychophysical and pain outcomes were evaluated pre- to post-injection. Results: A 22-year-old female with 24-month post-COVID-19 anosmia was recruited for the injection of PRP. The olfactory cleft endoscopic scale score was 0 and the threshold, discrimination and identification scores were 1, 8 and 0, respectively. The Olfactory Disorder Questionnaire score was 51. The patient benefited from the injection of 2.2 mL of PRP in nasal regions, which was done without complication. The procedure pain level was 2/10, while the local anesthesia with xylocaine 10% was judged as the most annoyance step with a score of 3/10. At 2-month post-injection, the TDI scores reached 16, 16, and 16 (48), while the Olfactory Disorder Questionnaire was 73. The patient described its recovery as very rapid, lasting 3-4 days, and occurring 3-week post-injection. Conclusion: The injection of PRP into the olfactory cleft is a safe and easiness new approach that may improve the recovery of smell sense.

Odontogenic infections are infections of the orofacial structures arising from dental disease. Despite its preventability, it exerts a significant burden on healthcare infrastructure worldwide. Our study explored the various different microbiological, social, and epidemiological characteristics of 103 cases of odontogenic infections at our regional center which demonstrated specific predilections for the young and middle-aged, those with diabetes mellitus, African American/Black and Hispanic ethnicities, posterior teeth, left-sided dentition, and male gender. However, nuances and exceptions to these trends were also seen with specific groups that may complicate treatment.

Generating a range-wide population status of the diamondback terrapin (Malaclemys terrapin spp.) is challenging due to a combination of species ecology and behavior, and limitations associated with traditional sampling methods. Visual counting of emergent heads offers an efficient, non-invasive and promising method for generating abundance estimates of terrapin populations across broader spatial scales and can be used to explain spatial variation in population size. We conducted repeated visual head count surveys at 38 predetermined sites along the shoreline of Wellfleet Bay in Wellfleet, Massachusetts. We analyzed the count data using a hierarchical modeling framework designed specifically to analyze repeated count data: the so-called N-mixture model. This approach allows for simultaneous modeling of imperfect detection to generate estimates of true terrapin abundance. We found detection probability was lowest when skies were overcast and when wind speed was highest. Site specific abundance varied but we found that abundance estimates were, on average, higher in unexposed sites compared to exposed sites. We demonstrate the utility of pairing visual head counts and N-mixture models as an efficient method for estimating terrapin abundance and show how the approach can be used to identifying environmental factors that influence detectability and distribution.

Macrobrachium rosenbergii is a valuable freshwater prawn in Asian aquaculture. In recent years, a new symptom that was generally called as ‘white head’ caused high mortality in M. rosenbergii farms in China. Samples of M. rosenbergii, M. nipponense, Procambarus clarkii, M. superbum, Penaeus vannamei, and Cladocera from a farm suffering from ‘white head’ in Jiangsu Province were collected and analyzed in this study. Pathogen detection showed that all samples were positive for Shrimp hemocyte iridescent virus (SHIV). Histopathological examination revealed dark eosinophilic inclusions and pyknosis in hematopoietic tissue, hepatopancreas and gills of M. rosenbergii and M. nipponense. Blue signals of in situ DIG-labeled LAMP (ISDL) appeared in hematopoietic tissue, hemocytes, hepatopancreatic sinus, and antennal gland. TEM of ultrathin sections showed a large number of SHIV particles with a mean diameter about 157.9 nm. The virogenic stromata and budding virions were observed in hematopoietic cells. Quantitative detection by TaqMan probe based real-time PCR of different tissues in natural infected M. rosenbergii showed that hematopoietic tissue contained the highest SHIV load with a relative abundance of (25.4±16.9)%. Hepatopancreas and muscle contained the lowest SHIV load with a relative abundance at (2.44±1.24)% and (2.44±2.16)%, respectively. Above results verified that SHIV is the pathogen causing ‘white head’ in M. rosenbergii, and M. nipponense and Pr. clarkii are also the susceptible species of SHIV.

Cyclic STAT3 decoy (CS3D) is a second-generation, double-stranded oligodeoxynucleotide (ODN) that mimics a genomic response element for signal transducer and activator of transcription 3 (STAT3), an oncogenic transcription factor. CS3D competitively inhibits STAT3 binding to target gene promoters, resulting in decreased expression of proteins that promote cellular proliferation and survival. Previous studies have demonstrated antitumor activity of CS3D in preclinical models of solid tumors. However, prior to entering human clinical trials, the efficiency of generating the CS3D molecule and its stability in biological fluids should be determined. CS3D is synthesized as a single-stranded ODN and must have its free ends ligated to generate the final cyclic form. In this study, we report a ligation efficiency of nearly 95 percent. The ligated CS3D demonstrated a half-life of 7.9 hours in human serum, indicating adequate stability for intravenous delivery. These results provide requisite biochemical characterization of CS3D that will inform upcoming clinical trials.

Purpose: To investigate the relationship of lamina cribrosa displacement to corneal biomechanical properties and visual function after mitomycin C-augmented trabeculectomy. Method: Eighty-one primary open angle eyes were imaged before and after trabeculectomy using an enhanced depth spectral-domain optical coherence tomography (SDOCT). Corneal biomechanical properties were measured with the Ocular Response Analyser before the surgery. The anterior lamina cribrosa (LC) was marked at several points in each of six radial scans to evaluate LC displacement in response to Intraocular pressure (IOP) reduction. A Humphrey visual field test (HVF) was performed before the surgery as well as three and six months postoperatively. Results: Factors associated with a deeper baseline anterior lamina cribrosa depth (ALD) were cup-disc ratio (P=0.04), baseline IOP (P= 0.01), corneal hysteresis (P= 0.001), and corneal resistance factor (P= 0.001). After the surgery, the position of LC became more anterior (negative), posterior (positive) or remained unchanged. The mean LC displacement was -42 μm (P= 0.001) and was positively correlated with the magnitude of IOP reduction (regression coefficient: 0.251, P=0.02), and negatively correlated with age (regression coefficient: - 0.224, P= 0.04) as well as baseline cup-disk ratio (Regression coefficient: -0.212,P= 0.05) Eyes with a larger negative LC displacement were more likely to experience an HVF improvement of more than 3 dB gain in mean deviation (P= 0.002). Conclusion: A lower SDOCT cup-disc ratio, younger age, and a larger IOP reduction were correlated with a larger negative LC displacement and improving HVF. Corneal biomechanics did not predict LC displacement.

Vein blood sampling is one of the methods of mass blood sampling, and is an act of drawing blood from a vein for blood type discrimination, confirmation of various physiological indicators, disease diagnosis, and the like, and is the most commonly used blood sampling method. An important point in vein blood sampling is to search for the exact location of the vein and insert the blood sampling. This is influenced by the patient's obesity, skin and blood vessel conditions, and the experience of the clinical technologist, nurse, and resident who performs the blood sampling. It is required to perform blood sampling technique practice. However, due to many limitations of the practice room or laboratory, there is a problem of using only a limited environment and model for clinical practice. As a result, many medical educational institutions have situations in which only fragmentary clinical practices are performed, and it is difficult to per-form a large number of blood sampling skills practices, so they do not provide enough experience to understand the actual skill field. In this paper, we propose a method for developing a virtual reality-based vein blood sampling simulator to practice a large number of blood sampling techniques without restrictions. The proposed vein blood sampling simulator can operate a 3D model related to vein blood sampling using HMD Controller and Haptic in a virtual space for vein blood sampling practice by wearing an HMD (Head mounted display), and can perform vein blood sampling practice through interaction with the patient 3D model. there is. In addition, the effectiveness of the simulator developed for dental students was verified, and as a result of the verification, the potential of the proposed vein blood sampling simulator was confirmed.

Cytokines are mediators of inflammation that could lead to fibrosis. The aim was to monitor cytokine levels in saliva and serum after locally fractionated radiotherapy of the head and neck in mice and investigate associations with salivary gland fibrosis and hyposalivation. C57BL/6 mice were randomized to sham or X-ray irradiation of 66 Gy in 10 fractions over 5 days. Blood and saliva were collected on day -7, 5, 35, 80 and 105 with following cytokine analysis. The harvested submandibular salivary gland was assessed for presence of fibrosis. Decision tree regression analysis was used to investigate whether cytokine levels could predict late endpoints in terms of hyposalivation or fibrosis. Significant formation of fibrosis in gland tissue and reduced saliva production was found after irradiation. The pro-inflammatory cytokines IL-1α, TNF, TIMP1, G-CSF, KC and MIP-1α showed increased levels in saliva in irradiated mice and strong correlation with late endpoints. The decision tree analysis largely separated controls from irradiated animals with IL-1α being the strongest predictor. Pro-inflammatory cytokines in saliva, but not in serum, were associated with late endpoints. This indicates that cytokine expression in saliva is a good biomarker for local salivary gland damage with IL-1α as the strongest single predictor.

Opium smoking for long hours and over many years is common in Iran, and the Covid-19 pan-demic and false beliefs about the protective effects of that opium against COVID-19 infection has caused the increasing of opium smoking during the pandemic. The aim of this study was to in-vestigate the relationship between non-ergonomic positions of traditional opium smoking in Iran with the occurrence of neck pain and disability, forward head posture and hyperkyphosis. In this cross-sectional and correlation study 120 people who smoke opium were selected based on the inclusion criteria and were interviewed about their addiction profile and evaluated for the pres-ence of pain and disability in the neck by Maudsley Addiction Profile, Leeds Dependence Ques-tionnaire, the Visual Analog Scale and Neck Disability Index. Also, they were evaluated about forward head posture (FHP) through side view photography and hyperkyphosis (HK) through flexible ruler. Data were analyzed by correlation coefficient tests and stepwise linear regression. There was a significant relation between homelessness, the duration of lifetime opium smoking (months), the duration of daily opium smoking (minutes) and drug dependence severity with the severity of neck pain, neck disability, forward head posture and hyperkyphosis. Homelessness is the strongest predictive variable of the possibility of neck pain and disability, FHP and HK, fol-lowed by ‘‘the number of months of opium smoking’’ and ‘‘the number of minutes of opium smoking in one day’’ respectively. Increasing the duration of sitting in non-ergonomic positions can lead to neck pain and disability, FHP and HK due to their non-neutral posture in opium smokers.

In response to reducing the energy cost of unmanned surface vehicles (USVs) while overcoming the low accuracy problem in surface target detection, a lightweight detection algorithm with multi-scale feature fusion is proposed. Based on the popular one-stage lightweight Yolov7-tiny target detection model, a lightweight extraction module is designed first by introducing the multiscale residual module to reduce the number of parameters and computational complexity while improving accuracy. The Mish and SiLU activation functions are used to enhance network feature extraction. Second, the path aggregation network employs coordinate convolution to strengthen spatial information perception. Finally, the dynamic head, which is based on the at-tention mechanism, improves the representation ability of object detection heads without any computational overhead. According to the experimental findings, the proposed model has 22.1% fewer parameters than the original model, 15% fewer GFLOPs, a 6.2% improvement in mAP@0.5, a 4.3% rise in mAP@0.5:0.95, and it satisfies the real-time criteria. According to the research, the suggested lightweight water surface detection approach includes a lighter model, a simpler computational architecture, more accuracy, and a wide range of generalizability. It performs bet-ter in a variety of difficult water surface circumstances.

Virtual Reality(VR) is an emerging technology with a broad range of application in training, entertainment, and business. To maximize the potentials of virtual reality as a medium, the unwelcome feeling of simulation sickness needs to be minimized. Even with advancements in VR, the usability concerns are barriers for a wide-spread acceptance. Several factors (hardware, software, human) play a part towards a pleasant VR experience. The reviewed scientific articles are mostly part of documents indexed in digital libraries. In this paper, we review the potential factors which cause simulation sickness and minimize the usability of virtual reality systems. We review the best practices from a developer’s perspective and some of the safety measures a user must follow while using the VR systems from existing research. Even after following some of the guidelines and best practices VR environments do not guarantee a pleasant experience for users. Limited research in VR environments towards requirement specification, design, and development for maximum usability and adaptability was the main motive for this work.

Total hip arthroplasty is a complex procedure. The achievements of implantology enabled the development of a faithful representation of hip joint physiology as well as the production of materials that can successfully replace damaged natural tissues. A very important issue is the correct selection of the geometry of the endoprosthesis adequate to the load of the joint. Materials used for endoprosthesis are a metal head and a polymer cup (e.g. PE-UHMW). The main interactions in the endoprosthesis are friction and surface pressure, which must be limited, exceeding them causes the destruction of the biomechanical system - plastic deformation of the polymer and the formation of too large and unacceptable radial clearances. Based on the author's developed calculation method of hip joint endoprosthesis contact parameters, the impact on maximum contact pressure and the angle of contact of the joint load was estimated depending on the diameter of the endoprosthesis and radial clearance. The correctness of changing the values of maximum contact pressure from the mentioned parameters was determined. Correspondingly: an increase in joint load causes a linear increase in the maximum contact pressure; increasing the diameter of the endoprosthesis head - their non-linear decrease, and increasing radial clearance - their increase

Cancer stem cells (CSCs) have been identified in many cancer types. This study identified and characterized CSCs in head and neck metastatic malignant melanoma (HNmMM) to regional lymph nodes using induced pluripotent stem cell (iPSC) markers. Immunohistochemical (IHC) staining performed on 20 HNmMM tissue samples demonstrated expression of iPSC markers OCT4, SOX2, KLF4 and c-MYC in all samples while NANOG was expressed at low levels in two samples. Immunofluorescence (IF) staining demonstrated an OCT4+/SOX2+/KLF4+/c-MYC+ CSC subpopulation within the tumor nests (TNs) and another within the peritumoral stroma (PTS) of HNmMM tissues. IF also showed expression of NANOG by some OCT4+/SOX2+/KLF4+/c-MYC+ cells within the TNs in an HNmMM tissue sample that expressed NANOG on IHC staining. In situ hybridization (n=6) and reverse-transcription quantitative polymerase chain reaction (n=5) on the HNmMM samples confirmed expression of all five iPSC markers. Western blotting of four primary cell lines derived from four of the 20 HNmMM tissue samples showed expression of SOX2, KLF4, and c-MYC but not OCT4 and NANOG, and three of these cell lines formed tumorspheres in vitro. We demonstrate the presence of two putative CSC subpopulations within HNmMM, which may be a novel therapeutic target in the treatment of this aggressive cancer.