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OPINION STATEMENT: Neoadjuvant immunotherapy will change the standard of care for advanced resectable cutaneous squamous cell carcinoma (cSCC) and possibly other non-melanoma skin cancers. With pathological complete response rates around 50% for cSCC in early studies, neoadjuvant therapy allows patients the possibility of significant reduction in tumor size, de-escalation of adjuvant therapy, and improved long-term outcomes. Patients must be carefully selected to ensure that there is a margin of safety with respect to resectability, such that if a tumor progresses on neoadjuvant therapy, there remains a curative surgical option that is acceptable to the patient. The optimal treatment paradigm is an area of active research, with many researchers questioning whether adjuvant therapy, or even local therapy, is necessary in patients who seem to have a complete response. The ability to predict who will respond will become even more critical to answer, as a significant number of patients do not want to risk their disease progressing, especially in cosmetically sensitive areas of the head and neck. Recent studies in melanoma show promise for improved response rates using combination therapies, and these strategies may apply to cSCC as well. The use of LAG-3 inhibitors or mRNA vaccine technology may further improve the utility of neoadjuvant strategies.
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Neoplasias de Cabeça e Pescoço , Imunoterapia , Terapia Neoadjuvante , Neoplasias Cutâneas , Humanos , Terapia Neoadjuvante/métodos , Neoplasias Cutâneas/terapia , Neoplasias de Cabeça e Pescoço/terapia , Imunoterapia/métodos , Resultado do Tratamento , Terapia Combinada/métodos , Terapia Combinada/efeitos adversos , Gerenciamento ClínicoRESUMO
The understanding of rider/vehicle interaction modalities remains an issue, specifically in the case of bend-taking. This difficulty results both from the lack of adequate instrumentation to conduct this type of study and from the variety of practices of this population of road users. Riders have numerous explanations of strategies for controlling their motorcycles when taking bends. The objective of this paper is to develop a data-driven methodology in order to identify typical riding behaviors in bends by using clustering methods. The real dataset used for the experiments is collected within the VIROLO++ collaborative project to improve the knowledge of actual PTW riding practices, especially during bend taking, by collecting real data on this riding situation, including data on PTW dynamics (velocity, normal acceleration, and jerk), position on the road (road curvature), and handlebar actions (handlebar steering angle). A detailed analysis of the results is provided for both the Anderson-Darling test and clustering steps. Moreover, the clustering results are compared with the subjective data of subjects to highlight and contextualize typical riding tendencies. Finally, we perform an in-depth analysis of the bend-taking practices of one subject to highlight the differences between different methods of controlling the motorcycle (steering handlebar vs. rider's lean) using the rider action measurements made by pressure sensors.
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Assistência Ambulatorial/métodos , COVID-19/prevenção & controle , Transplante de Rim , Distanciamento Físico , Cuidados Pós-Operatórios/métodos , Telemedicina/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Avaliação de Processos e Resultados em Cuidados de Saúde , PandemiasRESUMO
BACKGROUND: Injury and illness surveillance is the foundation for the development of prevention strategies. OBJECTIVE: To examine injuries among the aquatic disciplines in the 4â weeks prior to and during the 2013 FINA World Championships. METHODS: The study was comprised of two components: (1) a retrospective athlete survey recording injuries in the 4â weeks prior to the Championships and (2) a prospective recording of injuries and illnesses by the medical teams of the participating countries and the local host medical team. RESULTS: One-third of the 1116 responding athletes reported an injury/physical complaint in the 4â weeks prior to the Championships. Significantly more women (36.7%) than men (28.6%) reported injuries. Divers reported the highest rate of injury/physical complaints (55.7%). At the start of the Championships, 70% of injured respondents (n=258) were still symptomatic; however, full participation was expected by 76%. During the Championships, 186 new injuries were reported (8.3/100 registered athletes) with the highest injury incidence rate in water polo (15.3/100 registered athletes). The most common injured body part was the shoulder (21%). A total of 199 illnesses were reported during the Championships (9.0/100 registered athletes) with the most common diagnosis of illness being gastrointestinal infection. Environmental exposure (allergy, otitis and jellyfish stings) was responsible for 27% of all illnesses in open water swimming. CONCLUSIONS: Injuries pose a significant health risk for elite aquatic athletes. A prospective study would improve understanding of out-of-competition injuries. Future injury and illness surveillance at FINA World Championships is required to direct and measure the impact of prevention strategies.
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Mergulho/lesões , Natação/lesões , Adolescente , Adulto , Traumatismos em Atletas/fisiopatologia , Desempenho Atlético , Transtornos Traumáticos Cumulativos/etiologia , Transtornos Traumáticos Cumulativos/fisiopatologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Estudos Retrospectivos , Medicina Esportiva/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
Artificial intelligence (AI), particularly computer vision and large language models, will impact facial plastic and reconstructive surgery (FPRS) by enhancing diagnostic accuracy, refining surgical planning, and improving post-operative evaluations. These advancements can address subjective limitations of aesthetic surgery by providing objective tools for patient evaluation. Despite these advancements, AI in FPRS has yet to be fully integrated in the clinic setting and faces numerous challenges including algorithmic bias, ethical considerations, and need for validation. This article discusses current and emerging AI technologies in FPRS for the clinic setting, providing a glimpse of its future potential.
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The middle ear is a high-fidelity, broadband impedance transformer that transmits acoustic stimuli at the eardrum to the inner ear. It is home to the two smallest muscles in mammalian species, which modulate middle ear transmission. Of this pair, the function of the tensor tympani muscle (TTM) has remained obscure. We investigated the acoustic effects of this muscle in young adult gerbils. We measured changes in middle ear vibration produced by pulse-train-elicited TTM contraction - in the time-domain with a click stimulus and in the frequency-domain with multitone zwuis stimuli. In our click experiments, there was generally a small reduction in the primary peak of the response and a slight increase in the subsequent ringing, but there was essentially no change in the delay of the click response at the umbo (less than 1 µs change). In our multitone experiments, there were consistent patterns of attenuation and enhancement in the velocity responses at the umbo and ossicles. TTM contraction produced a narrow band of enhancement around 6 kHz (maximally ~5 dB) that can be modeled with an increased stiffness of an overdamped spring-mass resonance. At frequencies below 2 kHz and above 35 kHz, TTM contraction attenuated middle ear vibrations by as much as fivefold.