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For $E \subset \mathbb {N}$, a subset $R \subset \mathbb {N}$ is E-intersective if for every $A \subset E$ having positive relative density, $R \cap (A - A) \neq \varnothing $. We say that R is chromatically E-intersective if for every finite partition $E=\bigcup _{i=1}^k E_i$, there exists i such that $R\cap (E_i-E_i)\neq \varnothing $. When $E=\mathbb {N}$, we recover the usual notions of intersectivity and chromatic intersectivity. We investigate to what extent the known intersectivity results hold in the relative setting when $E = \mathbb {P}$, the set of primes, or other sparse subsets of $\mathbb {N}$. Among other things, we prove the following: (1) the set of shifted Chen primes $\mathbb {P}_{\mathrm {Chen}} + 1$ is both intersective and $\mathbb {P}$-intersective; (2) there exists an intersective set that is not $\mathbb {P}$-intersective; (3) every $\mathbb {P}$-intersective set is intersective; (4) there exists a chromatically $\mathbb {P}$-intersective set which is not intersective (and therefore not $\mathbb {P}$-intersective).
We consider an $\mathrm{M}/\mathrm{G}/\infty$ queue with infinite expected service time. We then provide the transience/recurrence classification of the states (the system is said to be at state n if there are n customers being served), observing also that here (unlike irreducible Markov chains, for example) it is possible for recurrent and transient states to coexist. We also prove a lower bound on the growth speed in the transient case.
We consider two continuous-time generalizations of conservative random walks introduced in Englander and Volkov (2022), an orthogonal and a spherically symmetrical one; the latter model is also known as random flights. For both models, we show the transience of the walks when $d\ge 2$ and that the rate of direction changing follows a power law $t^{-\alpha}$, $0<\alpha\le 1$, or the law $(\!\ln t)^{-\beta}$ where $\beta>2$.
Let $(X,\mu ,T,d)$ be a metric measure-preserving dynamical system such that three-fold correlations decay exponentially for Lipschitz continuous observables. Given a sequence $(M_k)$ that converges to $0$ slowly enough, we obtain a strong dynamical Borel–Cantelli result for recurrence, that is, for $\mu $-almost every $x\in X$,
where $\mu (B_k(x)) = M_k$. In particular, we show that this result holds for Axiom A diffeomorphisms and equilibrium states under certain assumptions.
Benign paroxysmal positional vertigo is the most common episodic vestibular disorder, although it is often quiescent by the time patients visit a specialist clinic, making the diagnosis difficult to confirm. Patients fear the consequences of a relapse and it is not clear what follow up should be provided.
Objective
This evaluation reviewed the results of an open access pathway that offered priority appointments to patients with a history of positional vertigo.
Results and conclusion
In total, 664 patients were included in the analysis, 52 per cent of whom had unconfirmed benign paroxysmal positional vertigo. Open follow up improved diagnostic rates by approximately 40 per cent. The rate of benign paroxysmal positional vertigo recurrence was 34 per cent in patients with follow up of at least one year, 41 per cent with follow up of one to two years, and 53 per cent with follow up of two years or more. One in five recurrences occurred in a different semi-circular canal. These results suggest that specialist follow up is required for management of recurrent benign paroxysmal positional vertigo.
In this chapter the basic theory of Markov chains is developed, with a focus on irreducible chains.The transition matrix is introduced as well as the notions of irreducibility, periodicity, recurrence (null and positive), and transience.The theory is applied to the relationship of a random walk on a group to the random walk on a finite-index subgroup induced by the "hitting measure."
The early prediction of adolescent depression recurrence poses a significant challenge in the field. This study aims to investigate and compare the abilities of the general psychopathology factor (p) and the specific internalizing factor, in predicting depression recurrence over a 2-year course, as well as identifying remitted depressed adolescents from healthy adolescents. Longitudinal changes of these two factors in different trajectory groups were also tracked to examine their sensitivity to sustained remission and relapse.
Methods
We included 255 baseline-remitted depressed adolescents and a healthy control group (n = 255) matched in age, sex, and race, sourced from the Adolescent Brain Cognitive Development Study. The linear mixed model was employed for the statistical analysis.
Results
The p factor not only effectively discriminated between remitted depressed adolescents and healthy controls but also robustly predicted the depression recurrence over a subsequent 2-year course. The specific internalizing factor could only differentiate remitted depressed adolescents from healthy controls. Additionally, a noteworthy longitudinal decline of the p factor in the sustained-remission group was observed.
Conclusions
Psychopathology factors serve as the inherent and enduring measurement of long-term mental health aberrations. Longitudinal results indicate that the p factor is more sensitive to respond to sustained remission than the internalizing factor. The ability of the overall p factor to anticipate depression relapse, unlike the specific internalizing factor, suggests the clinical interventions should monitor and mitigate the coincident symptoms across all dimensions to preempt relapse of adolescent depression, rather than an exclusive focus on internalizing symptoms.
In this chapter, we turn to martingales, which play a central role in probability theory. We illustrate their use in a number of applications to the analysis of discrete stochastic processes. After some background on stopping times and a brief review of basic martingale properties and results, we develop two major directions. We show how martingales can be used to derive a substantial generalization of our previous concentration inequalities – from the sums of independent random variables we focused on previously to nonlinear functions with Lipschitz properties. In particular, we give several applications of the method of bounded differences to random graphs. We also discuss bandit problems in machine learning. In the second thread, we give an introduction to potential theory and electrical network theory for Markov chains. This toolkit in particular provides bounds on hitting times for random walks on networks, with important implications in the study of recurrence among other applications. We also introduce Wilson’s remarkable method for generating uniform spanning trees.
We show a new method of estimating the Hausdorff measure of a set from below. The method requires computing the subsequent closest return times of a point to itself.
This study aimed to analyse clinical and radiological features (phenotypes) to predict revision risk after functional endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps.
Method
Phenotype characteristics of the patients with chronic rhinosinusitis with nasal polyps who underwent functional endoscopic sinus surgery were analysed retrospectively.
Results
The rates of asthma, aspirin sensitivity, smoking and a positive prick test result were significantly higher in revision functional endoscopic sinus surgery cases (p < 0.001, 0.001, < 0.001 and < 0.001, respectively). Multivariate analysis demonstrated that only gender, pre-operative nasal steroid use, pre-operative systemic steroid use, intra-operative systemic steroid use and smoking were significant risk factors for revision functional endoscopic sinus surgery (p = 0.034, 0.001, 0.010, 0.007 and 0.001, respectively). In addition, only eosinophilia and aspirin sensitivity were significant risk factors for multiple revision functional endoscopic sinus surgery procedures (p = 0.043 and 0.005, odds ratio = 2.4 and 5.2).
Conclusion
Beyond the endotype of chronic rhinosinusitis with nasal polyps, defining clinical and radiological factors enables a valid prediction of patients at high risk of revision functional endoscopic sinus surgery.
Depression is a highly recurrent disorder, with more than 50% of those affected experiencing a subsequent episode. Although there is relatively little stability in symptoms across episodes, some evidence indicates that suicidal ideation may be an exception. However, these findings warrant replication, especially over longer periods and across multiple episodes.
Aims
To assess the relative stability of suicidal ideation in comparison with other non-core depressive symptoms across episodes.
Method
We examined 490 individuals with current major depressive disorder (MDD) at baseline and at least one subsequent episode during 9-year follow-up within the Netherlands Study of Depression and Anxiety (NESDA). The Inventory of Depressive Symptomatology (IDS) was used to assess DSM-5 non-core MDD symptoms (fatigue, appetite/weight change, sleep disturbance, psychomotor disturbance, concentration difficulties, worthlessness/guilt, suicidal ideation) at baseline and 2-, 4-, 6- and 9-year follow-up. We examined consistency in symptom presentation (i.e. whether the symptom met the diagnostic threshold, based on a binary categorisation of the IDS) using kappa (κ) and percentage agreement, and stability in symptom severity using Spearman correlation, based on the continuous IDS scores.
Results
Out of all non-core depressive symptoms, insomnia appeared the most stable across episodes (r = 0.55–0.69, κ = 0.31–0.47) and weight decrease the least stable (r = 0.03–0.33, κ = 0.06–0.19). For suicidal ideation, correlations across episodes ranged from r = 0.36 to r = 0.55 and consistency ranged from κ = 0.28 to κ = 0.49.
Conclusions
Suicidal ideation is moderately stable in recurrent depression over 9 years. Contrary to prior reports, however, it does not exhibit substantially more stability than most other non-core symptoms of depression.
Retropharyngeal lymphadenectomy is challenging. This study investigated a minimally invasive approach to salvage retropharyngeal lymphadenectomy in patients with nasopharyngeal carcinoma.
Methods
An anatomical study of four fresh cadaveric heads was conducted to demonstrate the relevant details of retropharyngeal lymphadenectomy using the endoscopic transoral medial pterygomandibular fold approach. Six patients with nasopharyngeal cancer with retropharyngeal lymph node recurrence, who underwent retropharyngeal lymphadenectomy with the endoscopic transoral medial pterygomandibular fold technique at the Eye and ENT Hospital of Fudan University from July to December 2021, were included in this study.
Results
The anatomical study demonstrated that the endoscopic transoral medial pterygomandibular fold approach offers a short path and minimally invasive approach to the retropharyngeal space. The surgical procedure was well tolerated by all patients, with no significant post-operative complications.
Conclusion
The endoscopic transoral medial pterygomandibular fold approach is safe and efficient for retropharyngeal lymphadenectomy.
Auricular pseudocysts are rare, painless, benign intracartilaginous cysts of the auricle that are not lined by epithelium and have no known aetiology.
Method
This was a prospective study conducted in an ENT department from January 2020 to June 2022. In 21 patients, complete aspiration of the pseudocyst with enhanced negative drainage was performed. They were followed for a minimum of six months.
Results
All patients completely responded to the negative drainage treatment. No cases of recurrence or obvious deformities were observed.
Conclusion
Aspiration with intensified negative drainage was associated with a positive response in patients with auricular pseudocysts. Complete resolution of the swelling can be achieved without any serious complications. Thus, it appears to be a simple and effective method for managing the condition.
Edited by
Dennis S. Chi, Memorial Sloan-Kettering Cancer Center, New York,Nisha Lakhi, Richmond University Medical Center, Staten Island,Nicoletta Colombo, University of Milan-Bicocca
The treatment of recurrent ovarian cancer and the role of secondary cytoreductive surgery has been discussed for many years. Three phase III trials focused on that aspect with different results, including patients with the first relapse and a platinum-free interval of at least six months. The GOG 213 trial failed to show an OS benefit for patients with secondary cytoreduction. The interim analysis of the SOC1 trial showed a PFS benefit of 5.5 months (17.4 versus 11.9) favoring surgery, OS data are not mature yet. The DESKTOP III trial revealed an extraordinary OS benefit of 14.5 months for patients with complete resection compared to patients without surgery (60.7 vs. 46.2 months). Therefore, secondary cytoreductive surgery should be offered to suitable patients. The selection of the right patient (e.g. by AGO score) and the right center is the most important step to take to achieve the best results for our patients.
Secondary oesophageal carcinoma from a breast primary is an infrequent phenomenon. Given the rarity of this presentation, there is a general lack of consensus on management guidelines.
Materials and methods:
Herein, we report a case of a 65-year-old female presented with dysphagia, 14 years post-surgery for breast cancer. She was diagnosed with oesophageal metastases and was treated with combination of systemic chemotherapy, hormonal therapy and local radiotherapy. Our patient tolerated the treatment well and achieved a significant symptomatic improvement post-radiotherapy. We also performed a review of literature on oesophageal metastases from breast primary, aiming to improve the diagnostic accuracy and treatment efficacy in this rare presentation.
Conclusions:
We conclude that patients who present with persistent dysphagia post-breast cancer treatment should undergo an endoscopic ultrasound (EUS)-guided fine-needle biopsy (FNB) to rule out oesophageal metastasis. We suggest systemic chemotherapy with hormonal therapy and radiotherapy for local control as a management of choice in this condition. Even though prognosis is difficult to predict in these patients, this combined modality of treatment seems to achieve better overall survival.
Isocitrate dehydrogenase (IDH) mutation status is a key diagnostic and prognostic feature of gliomas. It is thought to occur early in glioma tumorigenesis and remain stable over time. However, there are reports documenting a loss of IDH mutation status in a subset of patients with glioma recurrence. Here, we identified patients with a documented loss of IDH mutation status longitudinally and performed multi-platform analysis in order to determine if IDH mutations are stable throughout glioma evolution.
Methods:
We retrospectively identified patients from our institution from 2009 to 2018 with immunohistochemistry (IHC)-recorded IDH mutation status changes longitudinally. Archived formalin-fixed paraffin-embedded and frozen tissue samples from these patients were collected from our institution’s tumour bank. Samples were analysed using methylation profiling, copy number variation, Sanger sequencing, droplet digital PCR (ddPCR) and IHC.
Results:
We reviewed 1491 archived glioma samples including 78 patients with multiple IDH mutant tumour samples collected longitudinally. In all instances of documented loss of IDH mutation status, multi-platform profiling identified a mixture of low tumour cell content and non-neoplastic tissue including perilesional, reactive or inflammatory cells.
Conclusions:
All patients with a documented loss of IDH mutation status longitudinally were resolved through multi-platform analysis. These findings support the hypothesis that IDH mutations occur early in gliomagenesis and in the absence of copy number changes at the IDH loci and are stable throughout tumour treatment and evolution. Our study highlights the importance of accurate surgical sampling and the role of DNA methylome profiling in diagnostically uncertain cases for integrated pathological and molecular diagnosis.
Takotsubo cardiomyopathy has an incidence of 1% of acute coronary syndrome in the adult population, and the risk of recurrence is approximately 1.5% per year. However, only a few cases have been reported in children. Having a neurologic disorder and being exposed to the same trigger repeatedly have been associated with an increased risk.
This study retrospectively analysed post-operative endoscopic scores to determine the optimal post-operative treatment in patients with eosinophilic chronic rhinosinusitis undergoing functional endoscopic sinus surgery.
Methods
In total, 339 adults who underwent initial bilateral functional endoscopic sinus surgery for eosinophilic chronic rhinosinusitis were enrolled. Patients were divided into group A, which required no additional post-operative treatment; group B, which required local/systemic steroids post-operatively; and group C, which further required dupilumab and/or revision surgery.
Results
Sixty-five per cent of patients could be treated with initial functional endoscopic sinus surgery (group A). Post-operative steroids were required in 35 per cent of patients with a post-operative endoscopic score of 30 per cent (group B). Further advanced treatments with dupilumab and/or revision functional endoscopic sinus surgery were required in 10 per cent of patients with a post-operative endoscopic score of 65 per cent (group C).
Conclusion
The post functional endoscopic sinus surgery endoscopic score can be used as an index to determine treatment at the time of eosinophilic chronic rhinosinusitis recurrence.
Sinonasal inverted papilloma has a high tendency for recurrence, local bone destruction and risk of malignant transformation. Therefore, complete resection of the tumour is required, and close follow up is essential. This article describes the clinical outcomes, recurrence rate and malignant transformation rate of sinonasal inverted papilloma.
Methods
In this study, 139 patients diagnosed with sinonasal inverted papilloma in our hospital from December 2010 to May 2022 were retrospectively analysed. All patients underwent endoscopic surgery.
Results
Sinonasal inverted papilloma occurred more often in males than in females. The mean age of patients with sinonasal inverted papilloma was 67.3 ± 5.7 years at diagnosis. The most prevalent site of origin was the maxillary sinus (50.4 per cent). The recurrence rate was 5.75 per cent, and the malignant transformation rate was 6.5 per cent.
Conclusion
All patients in this study underwent endoscopic surgery. Meticulous resection and regular long-term follow ups are crucial to reducing sinonasal inverted papilloma recurrence after surgery.
We introduce a broad class of multi-hooking networks, wherein multiple copies of a seed are hooked at each step at random locations, and the number of copies follows a predetermined building sequence of numbers. We analyze the degree profile in random multi-hooking networks by tracking two kinds of node degrees—the local average degree of a specific node over time and the global overall average degree in the graph. The former experiences phases and the latter is invariant with respect to the type of building sequence and is somewhat similar to the average degree in the initial seed. We also discuss the expected number of nodes of the smallest degree. Additionally, we study distances in the network through the lens of the average total path length, the average depth of a node, the eccentricity of a node, and the diameter of the graph.