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Κυριακή 17 Οκτωβρίου 2021

MiRNome analysis identifying miR‐205 and miR‐449a as biomarkers of disease progression in intestinal‐type sinonasal adenocarcinoma

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Abstract

Background

Patients with intestinal-type sinonasal adenocarcinoma (ITAC) have an unfavorable prognosis, and new diagnostic and therapeutic approaches are needed to improve clinical management.

Methods

Next-generation sequencing-based miRNome analysis was performed on 43 ITAC patients who underwent surgical resection, and microRNA (miRNA) data were obtained from 35 cases. Four miRNAs were identified, and their expression levels were detected by reverse-transcription quantitative polymerase chain reaction and related to the relevant patient outcome. Overall survival and disease-free survival rates were evaluated through the Kaplan–Meier method and log-rank test, and multivariate analysis was performed by means of Cox proportional hazard analysis.

Results

High levels of miR-205 and miR-34c/miR-449 cluster expression were associated with an increased recurrence risk and, therefore, a worse prognosis. Multivariate analysis confirmed that miR-205 and miR-449 were significant prognostic predictors.

Conclusions

A high expression of miR-205 and miR-449 is independent predictors of poor survival for ITAC patients.

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Marker‐less Augmented Reality based on Monocular Vision for Falx Meningioma Localization

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Abstract

Background

The existing augmented reality (AR) based neuronavigation systems typically require markers and additional tracking devices for model registration, which causes excessive preparatory steps.

Methods

For fast and accurate intraoperative navigation, this work proposes a marker-less AR system that tracks the head features with the monocular camera. After the semi-automatic initialization process, the feature points between the captured image and the pre-loaded keyframes are matched for obtaining correspondences. The camera pose is estimated by solving the Perspective-n-Point problem.

Results

The localization error of AR visualization on scalp and falx meningioma is 0.417 ± 0.057 and 1.413 ± 0.282 mm, respectively. The maximum localization error is less than 2 mm. The AR system is robust to occlusions and changes in viewpoint and scale.

Conclusions

We demonstrate that the developed system can successfully display the augmented falx meningioma with enough accuracy and provide guidance for neurosurgeons to locate the tumour in brain.

This article is protected by copyright. All rights reserved.

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The Impact of COVID‐19 on the presentation, stage and management of head and neck cancer patients: A real‐time assessment

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Abstract

During the Covid-19 pandemic, it was postulated that there might be a delay in cancer patients` presentation, stage migration, changes in management leading to excess cancer mortality [1]. However, there is a paucity of real-time objective data to support this, particularly in HNC. In our HNC multidisciplinary team (MDT), approximately 300 new patients present annually. The purpose of this observational study was to assess the impact of Covid-19 on the presentation, stage and management pattern on newly presented HNC patients during the pandemic era.

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De-escalation strategies in differentiated thyroid cancer

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Bull Cancer. 2021 Oct 11:S0007-4551(21)00367-2. doi: 10.1016/j.bulcan.2021.07.008. Online ahead of print.

ABSTRACT

Thyroid cancer runs the gamut from indolent micropapillary carcinoma to highly aggressive metastatic disease. Today, using prognostic algorithms, treatment and follow-up can be tailored to each patient in order to decrease overtreatment and over-medicalization of indolent disease. Active surveillance of papillary thyroid carcinoma less than 1cm avoids surgery and thyro id hormone replacement in a large proportion of patient whose tumors remain stable for years. Total thyroidectomy, once a dogma in the treatment of all thyroid cancer, is being supplanted by thyroid lobectomy for low-risk cancers, thereby decreasing the surgical risks involved and improving patients' quality of life. Indications for prophylactic central neck dissection, once mandatory, are now being adapted to the risk of cancer recurrence. Radioactive iodine therapy, also previously mandatory for all, is now only employed according to risk factors and expected outcomes. Follow-up is also being tailored to risk factors for recurrence, with less frequent visits and less use of ultrasound and scintigraphy. For more advanced disease, molecular therapies tailored to somatic mutations are opening opportunities for redifferentiation of aggressive tumors which become amenable to radioactive iodine therapy which carries fewer side effects than other systemic therapies. These advances in the management of thyroid cancer with a personalized approach and de-escalation of treatment and follow-up are improving the way we treat thyroid cancer, avoiding overtreatment and improving patients' quality of life.

PMID:34649722 | DOI:10.1016/j.bulcan.2021.07.008

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‘What you’ve got is a right to silence’: paraphrasing the right to silence and the meaning of rights

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In the Northern Territory of Australia (NT), it has long been recognised that the right to silence 'caution' is difficult to communicate, particularly with some Aboriginal suspects. This article reviews paraphrases used by NT police to explain the right, asking how they could be understood by Aboriginal people and offering initial conclusions about the meaning of paraphrases involving choice, rights and force. Meanwhile, the consequences of staying silent are consistently omitted from police paraphrases, highlighting that suspects must recover important meaning from context. This article argues that a significant source of contextual knowledge about the caution is discourses about rights, which are a complex and culture-specific way of thinking and talking. There is every risk that suspects without required contextual knowledge fail to obtain anything useful from many versions of the caution, a situation which likely entrenches disadvantage in the justic e system. To communicate the caution across a large cultural gap requires specifying more meaning, but only policy-makers can decide what information the caution is supposed to communicate and what effect it is supposed to have. Evaluation of potential cautions should ask whether they are comprehensible, informative and credible and ultimately what effect they have for relevant audiences.

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Style variability in disfluency analysis for forensic speaker comparison

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Disfluencies are a natural part of speech, often going unnoticed by both speaker and listener. Recent research on disfluency profiles (McDougall and Duckworth 2017, 2018) shows that they contain speaker-specific information which could be analysed and compared in forensic speaker comparison (FSC) casework. Since samples in FSC tend to be mismatched for speaking situation and style, the present study investigates the consistency of speakers' disfluency production across three forensically relevant tasks: a mock police interview, a paired conversation and a voicemail message. Disfluency production was found to differ significantly across tasks; in some cases, extreme within-speaker variation was observed. The results demonstrate that a speaker's disfluency behaviour is unlikely to remain consistent across different situations. However, it was found that some individuals who demonstrated unusual production of a particular type of disfluency showed relativel y consistent production of that type across all three tasks. Consequently, we recommend that disfluency analysis is not used in FSC where there are marked differences in speaking style or situation, unless distinctive disfluency production is observed in a sample.

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Language and Online Identities: The Undercover Policing of Sexual Crime Tim Grant and Nicci MacLeod (2020)

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Language and Online Identities: The Undercover Policing of Sexual Crime Tim Grant and Nicci MacLeod (2020) Cambridge University Press. 195 pp

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A forensic phonetic investigation of regional variation and accommodation in West Yorkshire

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This thesis presents an examination of regional variation and speech accommodation in two socially salient features of West Yorkshire English. The first aim of this research is to consider the extent to which local level variation exists across the West Yorkshire boroughs of Bradford, Kirklees and Wakefield. The second aim is to evaluate the effects of speech accommodation, the process whereby speakers adapt their speech production according to whom to they are talking (Giles, 1973; Giles & Powesland, 1975; Trudgill, 1981), in forensically-relevant contexts. The findings from these examinations inform how generalisable population data is for West Yorkshire across the three boroughs and also demonstrate to what extent accommodation could impact forensic speaker comparison (FSC) casework.

 

The specific features examined in this thesis are the West Yorkshire face vowel and word-medial, intervocalic /t/. The motivations for examining thes e variables are twofold. Firstly, previous investigations of West Yorkshire English have suggested that these variables may be realised in different ways across the region and secondly, both variables appear to be socially salient in the speech community under investigation. As speech accommodation has been found to occur more often and to a stronger degree with respect to features that are socially salient (Cao, 2018; Smith & Holmes-Elliott, 2015; Trudgill, 1986), it was expected that the participants in this investigation would accommodate in respect of these speech parameters. However, the main focus of this investigation is to examine the magnitude and direction of any accommodation behaviour, and to evaluate the potential consequences this may have for FSC outcomes.

 

This study is one of the first to make use of the newly published West Yorkshire Regional English Database (WYRED; Gold, Ross, & Earnshaw, 2018). The study analyses the speech of 30 male s from West Yorkshire recorded completing three semi-spontaneous speaking tasks that utilise different interlocutors. Participants are equally split across the boroughs of Bradford, Kirklees and Wakefield and form a homogenous population in terms of age, gender and language background, enabling a systematic evaluation of regional variation. For the analysis of face, measurements are taken of the first three formants at 25%, 50% and 75% across the total vowel duration. Using these measurements, a series of statistical analyses are conducted in order to establish levels of variability across boroughs and across tasks. Additionally, realisations of intervocalic /t/ are analysed auditorily and assessments of variability between boroughs are carried out as well as an examination of changes in T-glottaling rates across tasks. For both speech parameters, accommodation is evaluated using an acoustic-phonetic approach whereby the participants' realisations are considered in relation to tho se of their respective interlocutors.

 

The findings of the investigations presented in this thesis reveal that face productions vary at the local borough level, specifically in terms of midpoint F2 values, whereas /t/ productions are not regionally stratified across West Yorkshire. Based on these results, recommendations are outlined for delimiting the relevant population for FSC casework involving West Yorkshire speakers. With regards to speech accommodation in face and /t/, results show that accommodation behaviour is highly variable across participants, both in terms of the direction and amount of accommodation present. All participants were considered to accommodate in at least one speech parameter, and a small number of participants displayed very high levels of within-speaker variability across tasks, highlighting the level of potential impact that speech accommodation can have on socially salient speech parameters. The consequences of these findings are ad dressed from both a FSC casework perspective and also in terms of sociolinguistic research practices more generally.

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Interpreting as creating a potential for understanding: insights from a Danish courtroom

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According to a widespread norm among legal representatives, legal interpreters should translate verbatim, or at least as close to the source utterance as possible. Yet, sociolinguists have shown repeatedly that the absence of verbatim translation is not inherently problematic. Differences between source utterances and their translations may in fact facilitate understanding. On the basis of a corpus of audio-recordings from a court in Denmark, we analyse differences between a request presented by legal representatives and then the interpreters' versions. We focus on a routinised and procedural request, usually presented by the prosecutor and addressed to the judge, and very often conveyed in a highly implicit manner. We demonstrate that the interpreters tend to elaborate and add particular types of information in their translation. We argue that the additions facilitate understanding for the accused, as many inferences, based on institutional insight, are n eeded in order to understand what the prosecutor means. We also point to the paradox that, although interpreters are tasked with creating understanding, it is almost impossible to assess whether they succeed and what insight the accused obtains. This is due to the institutional organisation of the type of court hearing analysed.

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A Comparative Study on Outcomes of Type 1 Underlay Tympanoplasty with and Without Anterior Tucking of Temporals Fascia Graft

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Abstract

Tympanoplasty is a surgical procedure which includes eradication of disease from the middle ear and reconstruction of the hearing mechanism with or without tympanic membrane repair. The purpose of this article was to compare the clinical and audiological outcomes of Type 1 underlay tympanoplasty with or without anterior tucking of the temporals fascia graft. This is a prospective interventional study which included 100 patients between 15 and 60 years of age, diagnosed with chronic otitis media, mucosal disease inactive stage. 100 patients were divided into two groups 50 each, who underwent type 1 underlay tympanoplasty, group A underwent anterior tucking of the temporals fascia graft and group B without anterior tucking of the temporals fascia graft. Analysis of data was made of the demographic details, graft uptake status and audiological outcomes following surgery. Among the 100 patients included in the study, majority were seen between 21 and 40 yea rs of age group. In our study successful graft uptake was seen in 93.4% in group A temporalis fascia with anterior tucking which was better than group B which showed 84% results. However hearing outcome was almost similar in both the groups. In conclusion, graft uptake in tympanoplasty with anterior tucking was found to be better than without anterior tucking. There is significant hearing improvement following underlay technique of tympanoplasty both with and without anterior tucking. There is no significant difference in the hearing improvement with anterior tucking when compared to without anterior tucking of the temporalis fascia graft.

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A Comparative Study on Outcomes of Type 1 Underlay Tympanoplasty with and Without Anterior Tucking of Temporals Fascia Graft

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Abstract

Tympanoplasty is a surgical procedure which includes eradication of disease from the middle ear and reconstruction of the hearing mechanism with or without tympanic membrane repair. The purpose of this article was to compare the clinical and audiological outcomes of Type 1 underlay tympanoplasty with or without anterior tucking of the temporals fascia graft. This is a prospective interventional study which included 100 patients between 15 and 60 years of age, diagnosed with chronic otitis media, mucosal disease inactive stage. 100 patients were divided into two groups 50 each, who underwent type 1 underlay tympanoplasty, group A underwent anterior tucking of the temporals fascia graft and group B without anterior tucking of the temporals fascia graft. Analysis of data was made of the demographic details, graft uptake status and audiological outcomes following surgery. Among the 100 patients included in the study, majority were seen between 21 and 40 yea rs of age group. In our study successful graft uptake was seen in 93.4% in group A temporalis fascia with anterior tucking which was better than group B which showed 84% results. However hearing outcome was almost similar in both the groups. In conclusion, graft uptake in tympanoplasty with anterior tucking was found to be better than without anterior tucking. There is significant hearing improvement following underlay technique of tympanoplasty both with and without anterior tucking. There is no significant difference in the hearing improvement with anterior tucking when compared to without anterior tucking of the temporalis fascia graft.

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Outcomes of Training Nurses Engaged in a Public Sector Newborn Hearing Screening Program in South India

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Abstract

This study evaluated the outcomes of training nurses engaged in a public sector newborn hearing screening (NHS) program in one urban district in South India. Twenty nurses performing NHS in Corporation Maternity Hospitals (CMH) participated in the training and evaluation. Baseline knowledge and skill of nurses regarding NHS and overall program outcomes were obtained eight months post the initial training. Knowledge was evaluated using questionnaire, skill was evaluated using Objective Structured Clinical Examination (OSCE) and agreement between screening results obtained by audiologist and nurse. Records used for documentation of screening were analysed to evaluate program outcomes. A two-day retraining was designed to address the gaps identified. Evaluations were conducted immediately post and three months post retraining following the same procedure as baseline evaluations. Gaps were identified in knowledge and skill as well as in the program outcomes. Immediat e post retraining evaluation results showed overall improvement in nurses' knowledge and skill. Three months post retraining, all the nurses achieved benchmark criteria of 75% in knowledge and skill. Program outcomes, such as coverage (95.3%), refer rate (3.2%) and follow up rate (86.1%) improved post retraining. The findings of this study suggests that knowledge and skill of nurses improved with periodic training. Periodic evaluation and monitoring enhanced the overall outcomes of the program.

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