It is well established that not only vision but also other sensory modalities affect drivers' control of their vehicles, and that drivers adapt over time to persistent changes in sensory cues (for example in driving simulators), but the mechanisms underlying these behavioural phenomena are poorly understood. Here, we consider the existing literature on how driver steering in slalom tasks is affected by the down-scaling of vestibular cues, and propose a driver model that can explain the empirically observed effects, namely: decreased task performance and increased steering effort during initial exposure, followed by a partial reversal of these effects as task exposure is prolonged. Unexpectedly, the model also reproduced another empirical finding: a local optimum for motion down-scaling, where path-tracking is better than when one-to-one motion cues are available. Overall, the results imply that: (1) drivers make direct use of vestibular information as part of determining appropriate steering, and (2) motion down-scaling causes a yaw rate underestimation phenomenon, where drivers behave as if the simulated vehicle is rotating more slowly than it is. However, (3) in the slalom task, a certain degree of such yaw rate underestimation is beneficial to path tracking performance. Furthermore, (4) behavioural adaptation, as empirically observed in slalom tasks, may occur due to (a) down-weighting of vestibular cues, and/or (b) increased sensitivity to control errors, in determining when to adjust steering and by how much, but (c) seemingly not in the form of a full compensatory rescaling of the received vestibular input. The analyses presented here provide new insights and hypotheses about simulator driving, and the developed models can be used to support research on multisensory integration and behavioural adaptation in both driving and other task domains.
Aims: To evaluate patterns of locoregional recurrence following adjuvant (chemo)radiotherapy for oral cavity squamous cell carcinomas. Materials and methods: One hundred and one patients who received adjuvant radiotherapy AE chemotherapy for oral cavity squamous cell carcinoma between 2013 and 2016 were analysed. For documented locoregional recurrence, recurrence imaging was deformably co-registered to the planning computed tomography scan. The volume of recurrence was delineated (Vrec). Vrec coverage by 95% of the corresponding planning target volume prescription dose was determined and the location compared with planning target volumes. Sites of recurrence were classified using a combined volume and centroid-based method: (A) central high dose, (B) peripheral high dose, (C) central low dose, (D) central peripheral dose, (E) extraneous. Results: The median follow-up was 36 months. Forty-three per cent and 53% of patients received radiotherapy to the ipsilateral neck only and bilateral neck, respectively. Three-year overall survival, disease-free survival, local control, regional control and distant metastases-free survival were 63.0, 65.6, 88.0, 85.1 and 85.3%, respectively. Of 10 episodes of primary site recurrences, five were type A, four type B and one was type E. Of 14 episodes of regional recurrence, five were type A, two type C, two type D and five type E. Five of 21 (24%) patients with oral tongue carcinoma with an undissected/unirradiated contralateral neck had a type E contralateral neck recurrence, including 2/11 with pN0, 1/4 with pN1 and 2/6 with pN2 disease. Conclusions: Marginal and out-of-field recurrences remain a significant pattern of failure. We advocate generous target delineation postoperatively and, for oral tongue carcinomas, a comprehensive approach with bilateral neck irradiation.
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