•In laryngeal oncology it is crucial to assess mobility of vocal cord-arytenoid unit.•Current mobility assessment is flawed by weak inter-observer agreement.•Tumor extension assessment by dedicated ...radiologists is recommended.
In clinical practice the assessment of the “vocal cord-arytenoid unit” (VCAU) mobility is crucial in the staging, prognosis, and choice of treatment of laryngeal squamous cell carcinoma (LSCC). The aim of the present study was to measure repeatability and reliability of clinical assessment of VCAU mobility and radiologic analysis of posterior laryngeal extension.
In this multi-institutional retrospective study, patients with LSCC-induced impairment of VCAU mobility who received curative treatment were included; pre-treatment endoscopy and contrast-enhanced imaging were collected and evaluated by raters. According to their evaluations, concordance, number of assigned categories, and inter- and intra-rater agreement were calculated.
Twenty-two otorhinolaryngologists evaluated 366 videolaryngoscopies (total evaluations: 2170) and 6 radiologists evaluated 237 imaging studies (total evaluations: 477). The concordance of clinical rating was excellent in only 22.7% of cases. Overall, inter- and intra-rater agreement was weak. Supraglottic cancers and transoral endoscopy were associated with the lowest inter-observer reliability values. Radiologic inter-rater agreement was low and did not vary with imaging technique. Intra-rater reliability of radiologic evaluation was optimal.
The current methods to assess VCAU mobility and posterior extension of LSCC are flawed by weak inter-observer agreement and reliability. Radiologic evaluation was characterized by very high intra-rater agreement, but weak inter-observer reliability. The relevance of VCAU mobility assessment in laryngeal oncology should be re-weighted. Patients affected by LSCC requiring imaging should be referred to dedicated radiologists with experience in head and neck oncology.
The ability of pathogens to sequester iron from their host cells and proteins affects their virulence. Moreover, iron is required for various innate host defense mechanisms as well as for acquired ...immune responses. Therefore, intracellular iron concentration may influence the interplay between pathogens and immune system. Here, we investigated whether changes in iron concentrations and intracellular ferritin heavy chain (FTH) abundance may modulate the expression of Major Histocompatibility Complex molecules (MHC), and susceptibility to Natural Killer (NK) cell cytotoxicity. FTH downregulation, either by shRNA transfection or iron chelation, led to MHC surface reduction in primary cancer cells and macrophages. On the contrary, mouse embryonic fibroblasts (MEFs) from NCOA4 null mice accumulated FTH for ferritinophagy impairment and displayed MHC class I cell surface overexpression. Low iron concentration, but not FTH, interfered with IFN-γ receptor signaling, preventing the increase of MHC-class I molecules on the membrane by obstructing STAT1 phosphorylation and nuclear translocation. Finally, iron depletion and FTH downregulation increased the target susceptibility of both primary cancer cells and macrophages to NK cell recognition. In conclusion, the reduction of iron and FTH may influence the expression of MHC class I molecules leading to NK cells activation.
The goal of this research was to optimize performance of a Computer-Aided Diagnostic system to identify, analyze and compare breast masses based on parameters measured in the ultrasound image. We ...compared case-based reasoning using Relative Similarity to an Artificial Neural Network in order to implement an objective form of the ACR BIRADS scheme to describe and score breast masses. The image feature set was reduced to nine including margins, shape, echogenicity, echo texture, orientation and posterior acoustic attenuation. Both classifiers performed well with a high ROC AZ although RS performed significantly better than the ANN in Specificity, PPV and achieved the goal of very high Specificity without a reduction in Sensitivity. Compared to a preliminary version of the RS classifier this optimized version of RS has significantly higher AZ (0.96 vs. 0.93)
We developed a sophisticated computer-aided diagnostic system optimized to the specific application of standardizing interpretation of diagnostic breast ultrasound. The implemented Computer-Aided ...Diagnostic tool was evaluated on a database of 332 cases with findings known (“truth”) via biopsy or two-year benign follow up. These same cases were interpreted by a group of four experienced radiologists. Performance of the developed CAD was measured as Sensitivity, Specificity, PPV, NPV and ROC Area (AZ). For the CAIS AZ=0.96, which exceeded the performance of four expert radiologists (average AZ=0.86). AZ for the radiologists was not significantly different (0.86, 0.85, 0.87, 0.86 ± 0.03). Statistical Power for the study was 93%. The excellent performance of CAIS appears to justify further evaluation in a clinical setting to determine its impact on decision making
In this paper an alternative method to achieve distance based formation is presented. The method uses Genetic Algorithms to find a suitable solution based on angle and distance, and an appropriate ...constant velocity to avoid collisions. The designed algorithm is extended to a parallel scheme to improve its performance and achieve Artificial Distributed Intelligence, in which the robots share, through solution migration, the best ways to converge to desired distances while avoiding collisions, finally reaching consensus on the solution. The algorithm is tested using simulations and real robots experiments.
•A method to achieve distance based formation using GA is presented.•The parallel algorithm achieves Artificial Distributed Intelligence.•The designed algorithm avoids inter robot collisions.•The algorithm is tested using simulations and real robots experiments.•Experiments show the use of the algorithm to coordinate the movements of MRS.
Producing colored coatings by Physical Vapor Deposition (PVD) in an in-line way is an interesting industrializing process. Moreover, the durability of vacuum coatings is an advantage for ...architectural applications such as outdoor decoration. In this project, titanium dioxide coatings were produced over moving stainless steel wires via direct current (DC) reactive magnetron sputtering PVD in an inverted cylindrical magnetron. The samples were characterized by transmission electron microscopy (TEM) coupled with ASTAR (Automated crystal orientation mapping on TEM -ACOM- with precession tool -DigiSTAR-) orientation-phase mapping and EDS (Energy Dispersive X-ray Spectroscopy) chemical mapping. The microstructure of TiOx thin films is analyzed as a function of the O2 flux in the chamber. In the metallic mode, a 300 nm polycrystalline hexagonal Ti film is obtained in 2 min 30 s at 1000 W. For the same power and same time but in the poisoned mode, a 40 nm titanium dioxide film composed of both rutile and anatase columnar grains is obtained. A peculiar mode is the transition one, where in a single pass through the chamber a multilayer of ≈230 nm hexagonal Ti and ≈70 nm pure rutile titanium dioxide is grown. This multilayer is a result of a heterogeneous magnetic field, hence of the chamber poisoning. All these thin films present chemical, structure and grain size gradients because of an original process (in-line and cylindrical inverted magnetron) with plasma density heterogeneity.
•Orientation & phase ASTAR-TEM maps of TiOx PVD coatings are described with a nanometric resolution.•Thin films have structural gradients coming from an in-line with plasma heterogeneity.•Depending on the p(O2), three kinds of multilayers are grown.
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