The aim of this study was to analyse the diagnostic value of selected glyco- and immunohistochemical probes for discrimination between mesotheliomas and metastatic carcinomas within the pleura, and to evaluate prognostic indicators in the tested panel. A panel of nine markers (five antibodies, two neoglycoproteins, and labelled hyaluronic acid) was applied to a total of 264 specimens with mesotheliomas (118 cases) and metastatic carcinomas in the pleura (146 cases); the material consisted exclusively of surgical specimens. The diagnosis obtained by standard procedures was further substantiated through a detailed follow-up and clear-cut descriptions of primary sites. The metastatic tumours originated from the lung (82 cases), breast (47 cases), colon (three cases), and kidney (two cases); in 12 cases, however, the tumour origin could not be ascertained. In detail, the probes tested included antibodies against carcinoembryonic antigen (CEA), vimentin, calretinin, mesothelial cells (HBME-1), calcyclin and keratin-5; and also biotinylated neoglycoproteins with ganglioside GM1 and N-acetyl-D-glucosamine (GlcNAc) as the ligand part, and hyaluronic acid. Carrier-immobilized ganglioside GM1 and hyaluronic acid displayed the highest specificity and sensitivity for mesotheliomas, followed by calretinin and HBME-1, whereas keratin-5 and vimentin were of low specificity (43% and 52%, respectively). Metastatic carcinomas could be discerned by CEA detection and application of GlcNAc-bearing neoglycoprotein with similar sensitivity (76% and 72%, respectively) and specificity (91% and 86%, respectively). In cases of breast carcinoma, the maximum specificity (59%) and sensitivity (67%) were low for all markers. Patients with mesothelioma survived longer than those with metastatic carcinoma, especially those with detectable binding sites for hyaluronic acid. No association of tumour type and binding properties of the other applied probes with survival of the patients could be found at a statistically significant level. It is concluded that in routine practice, the application of carrier-immobilized GM1, hyaluronic acid, and antibodies against calretinin and HBME-1 is useful for confirmation of mesothelioma, whereas the detection of CEA and GlcNAc-specific binding sites is useful for distinguishing metastatic carcinoma from mesothelioma. Despite the rather infrequent occurrence of mesotheliomas in women, particular attention should be given to exclude or confirm metastatic breast carcinoma in cases of unknown history or long metastatic interval.
Objectives: Cricotracheal resection is a modern technique of airway reconstruction used in cases of subglottic stenosis. We report a case series of adult, nontracheotomized patients. Methods: Fifteen patients with significant subglottic stenosis were identified as presenting with dyspnea and stridor. The stenosis was grade III in 14 cases and grade II in 1 case, according to the Cotton classification. The causes were manifold, with intubation and tracheostomy being the predominant risk factors. Cricotracheal resection was performed in all cases with preoperative and postoperative videotracheoscopy. Results: The mean postoperative intubation time was 41.7 hours (11 to 103 hours), and the mean length of stay in the intensive care unit was 2.6 days (3 to 9 days). Videotracheoscopy for reassessment was performed after 96 days (average). In 13 of the 15 patients the subglottic lumen was returned to a normal diameter. In 1 case a recurrent stenosis was managed with repeated endoscopic interventions. One patient died on postoperative day 4 because of a pulmonary embolism. Additional complications consisted of 1 axillary venous embolism, 4 cases of ventilator-associated pneumonia, and 1 case of transient unilateral recurrent nerve palsy that recovered completely. Conclusions: Cricotracheal resection is a reliable and versatile technique for the reconstruction of the subglottic airway, almost regardless of the underlying cause. Most complications observed have not been associated directly with the procedure, but reflect the significant comorbidity of the patient population. There seems to be an increased risk for thromboembolic events that may be a consequence of the preoperative immobilization of dyspneic patients.
In this work we investigated sensemaking activities on different immersive platforms. We observed user s during a classification task on a very large wall-display system (experiment I) and in a modern Virtual Reality headset (experiment II). In experiment II, we also evaluated a condition with a VR headset with an extended field of view, through a sparse peripheral display. We evaluated the results across the two studies by analyzing quantitative and qualitative data, such as task completion time, number of classifications, followed strategies, and shape of clusters. The results showed differences in user behaviors between the different immersive platforms, i.e., the very large display wall and the VR headset. Even though quantitative data showed no significant differences, qualitatively, users used additional strategies on the wall-display, which hints at a deeper level of sensemaking compared to a VR Headset. The qualitative and quantitative results of the comparison between VR Headsets do not indicate that users perform differently with a VR Headset with an extended field of view.
The ability to anticipate team members' actions enables joint action towards a common goal. Task knowledge and mental simulation allow for anticipating other agents' actions and for making inferences about their underlying mental representations. In human-AI teams, providing AI agents with anticipatory mechanisms can facilitate collaboration and successful execution of joint action. This paper presents a computational cognitive model demonstrating mental simulation of operators' mental models of a situation and anticipation of their behavior. The work proposes two successive steps: (1) A hierarchical cluster algorithm is applied to recognize patterns of behavior among pilots. These behavioral clusters are used to derive commonalities in situation models from empirical data (N = 13 pilots).(2) An ACT-R (adaptive control of thought -rational) cognitive model is implemented to mentally simulate different possible outcomes of action decisions and timing of a pilot. model tracing of ACT-R allows following up on operators' individual actions. Two models are implemented using the symbolic representations of ACT-R: one simulating normative behavior and the other by simulating individual differences and using subsymbolic learning. Model performance is analyzed by a comparison of both models. Results indicate the improved performance of the individual differences over the normative
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