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© 2019 Elsevier B.V. The authors regret that due to insufficient accuracy when approving the final version, the required changes in affiliations are updated as above. The authors would like to apologise for any inconvenience caused.

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Geopolymers are ecologically-friendly inorganic materials which can be produced at low temperatures from industrial wastes such as fly ash, blast furnace slags or mining residues. Although to date their principal applications have been seen as alternatives to Portland cement building materials, their properties make them suitable for a number of more advanced applications, including as photocatalytic nanocomposites for removal of hazardous pollutants from waste water or the atmosphere. For this purpose, they can be combined with photocatalytic moieties such as metal oxides with suitable bandgaps to couple with UV or visible radiation, or with carbon nanotubes or graphene. In these composites the geopolymers act as supports for the photoactive components, but geopolymers formed from wastes containing oxides such as Fe2O3 show intrinsic photoactive behaviour. This review discusses the structure and formation chemistry of geopolymers and the principles required for their utilisation as photocatalysts. The literature on existing photocatalytic geopolymers is reviewed, suggesting that these materials have a promising potential as inexpensive, efficient and ecologically-friendly candidates for the remediation of toxic environmental pollutants and would repay further development.

Background: We investigated long‐term survival from head and neck cancer (HNC) using different survival approaches. Methods: Patients were followed‐up from the Scottish Audit of Head and Neck Cancer. Overall survival and disease‐specific survival were calculated using the Kaplan–Meier method. Net survival was calculated by the Pohar‐Perme method. Mutually adjusted Cox proportional hazards models were used to determine the predictors of survival. Results: A total of 1820 patients were included in the analyses. Overall survival at 12 years was 26.3% (24.3%, 28.3%). Disease‐specific survival at 12 years was 56.9% (54.3%, 59.4%). Net survival at 12 years was 41.4% (37.6%, 45.1%). Conclusion: Determinants associated with long‐term survival included age, stage, treatment modality, WHO performance status, alcohol consumption, smoking behavior, and anatomical site. We recommend that net survival is used for long‐term outcomes for HNC patients—it disentangles other causes of death, which are overestimated in overall survival and underestimated in disease‐specific survival.

INTRODUCTION AND OBJECTIVE:The aim of this study was to determine the prevalence of urinary tract cancer (UTC) in secondary care. Secondary aims were to explore reasons for differences in prevalenc...

User-defined tokens—both fungible ERC-20 and non-fungible ERC-721 tokens—are central to the majority of contracts deployed on Ethereum. User-defined tokens are non-native on Ethereum; i.e., they are not directly supported by the ledger, but require custom code. This makes them unnecessarily inefficient, expensive, and complex.

Bitcoin and Ethereum, hosting the two currently most valuable and popular cryptocurrencies, use two rather different ledger models, known as the UTXO model and the account model, respectively. At the same time, these two public blockchains differ strongly in the expressiveness of the smart contracts that they support. This is no coincidence. Ethereum chose the account model explicitly to facilitate more expressive smart contracts. On the other hand, Bitcoin chose UTXO also for good reasons, including that its semantic model stays simple in a complex concurrent and distributed computing environment. This raises the question of whether it is possible to have expressive smart contracts, while keeping the semantic simplicity of the UTXO model.

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. In the absence of high-level evidence base for follow-up practices, the duration and frequency are often at the discretion of local centres. By reviewing the existing literature and collating experience from varying practices across the UK, this paper provides recommendations on the work up and management of lateral skull base cancer based on the existing evidence base for this rare condition.Recommendations• Patients should be followed up to a minimum of five years with a prolonged follow-up for selected patients. (G)• Patients should be followed up at least two monthly in the first two years and three to six monthly in the subsequent years. (G)• Patients should be seen in dedicated multidisciplinary head and neck oncology clinics. (G)• Patients should be followed up by dedicated multidisciplinary clinical teams. (G)• The multidisciplinary follow-up team should include clinical nurse specialists, speech and language therapists, dietitians and other allied health professionals in the role of key workers. (G)• Clinical assessment should include adequate clinical examination including fibre-optic rigid or flexible nasopharyngolaryngoscopy. (R)• Magnetic resonance imaging and positron emission tomography combined with computed tomography imaging should be used when recurrence is suspected. (R)• Narrow band imaging can be used in the follow-up in selected sites. (R)• Second primary tumours should be part of rationale of follow-up and therefore adequate screening strategies should be used to detect them. (G)• Patients should be educated with regard to the appearance and detection of recurrences. (G)• Patients with persistent pain should be investigated to exclude recurrent disease. (R)• Patients should be offered support with tobacco and alcohol cessation services. (R)

Background: Socioeconomic inequalities impact on the survival of head and neck cancer (HNC) patients, but there is limited understanding of the explanations of the inequality, particularly in long-term survival.\ud \ud Methods: Patients were recruited from the Scottish Audit of Head and Neck Cancer between 1999 and 2001 and were linked to mortality data as at 30th September 2013. Socioeconomic status was determined using the area-based Carstairs 2001 index. Overall and disease-specific survival were calculated using the Kaplan-Meier method with 95% confidence intervals (CI's) at 1-, 5-, and 12-years. Net survival at 1-, 5-, and 12-years was also computed with 95% CIs. Cox proportional hazard models with 95% CIs were used to determine the explanations for the inequality in survival by all-cause mortality and disease-specific mortality with 95% CIs.\ud \ud Results: Most patients were from the most deprived group, and were more likely to smoke, drink, have cancer of a higher stage and have a lower WHO Performance Status. A clear gradient across Carstairs fifths for unadjusted overall and disease-specific survival was observed at 1-, 5-, and 12-years for patients with HNC. Following the adjustment for multiple patient, tumor and treatment factors, the inequality in survival for patients with HNC had attenuated and was no longer statistically significant at 1-, 5-, and 12-years.\ud \ud Conclusion: A clear gradient across Carstairs fifths for unadjusted overall, disease-specific and net survival was observed at 1-, 5-, and 12-years for HNC patients in Scotland from 1999 to 2001. This study concludes that explanations for the inequality in the survival of patients with HNC are not straightforward, and that many factors including various patient, tumor and treatment factors play a part in the inequality in the survival of patients with HNC.

Lambda calculi are often used as intermediate representations for compilers. However, they require extensions to handle higher-level features of programming languages. In this paper we show how to construct an IR based on \(\text {System}\ F_{\omega }^\mu \) which supports recursive functions and datatypes, and describe how to compile it to \(\text {System}\ F_{\omega }^\mu \). Our IR was developed for commercial use at the IOHK company, where it is used as part of a compilation pipeline for smart contracts running on a blockchain.

OBJECTIVE: To evaluate diagnostic performance of the emotional domain of the VoiSS questionnaire compared with the Hospital Anxiety and Depression Scale (HADS).DESIGN: Cross sectional questionnaire study.SETTING: Tertiary referral centre voice clinic.PARTICIPANTS: 210 consecutive voice clinic patients.MAIN OUTCOME MEASURES: Screening with VoiSS and HADS questionnaires. Paired comparison, correlation, multinomial logistic regression and receiver operating characteristic (ROC) curve analysis.RESULTS: 177 returned complete datasets. 96 patients (54.2%) had functional dysphonia and 81(45.8%) had organic laryngeal disorders. Mean total VoiSS score =39.7/120 (standard deviation (SD) 22.2). Mean emotional VoiSS subscale =7.6/22 (SD 7.5). Mean HAD anxiety =6.5/21 (SD 5.2) and depression mean =7.1/21 (SD 4.8). There were 35 (20%) borderline anxiety and/or depression scores and 30 (17%) scores considered positive for "caseness". There was strong correlation between emotional VoiSS and HADS anxiety (Spearman's Rho= 0.68, p < .001) and HADS depression (Spearman's Rho= 0.62, p < .001). ROC curve analysis exhibited significant association between emotional VoiSS and HADS "caseness" (area under curve =0.88). In addition functional dysphonia patients had lower mean VoiSS and HADS scores than patients with identifiable laryngeal abnormalities.CONCLUSION: The VoiSS emotional subscale strongly correlates with HADS anxiety and depression scores and could be used as a measure of psychological distress. This could allow targeted psychological strategies, without additional psychometric questionnaires. Functional dysphonia has less association with psychological distress than certain organic laryngological disorders. This article is protected by copyright. All rights reserved.

To assess the accuracy of initial combined cytological accuracy and radiological staging of patients suspected of having thyroid malignancy with their final histopathology. Retrospective case series in a tertiary referral centre for head and neck malignancy. All patients with malignant thyroid cytology and cytology suspicious for malignancy, between the dates of June 2010 and July 2014, were included. The pre-operative staging was compared against the final histological staging. Demographics and outcomes for each patient were recorded. Sixty-five patients were recorded in this group. 20 (30.7 %) were male. The mean age at presentation was 51 years (SD 16.8 years). 39 (60 %) patients were aged over 45 years. Fine needle aspiration cytology (FNAC) was performed in all patients and was Thy 4 in 40 (62 %) and Thy 5 in 25 (38 %). Following surgery or subsequent biopsy, FNAC was found to be accurate in 38/40 (Thy 4) and 25/25 (Thy 5) cases in diagnosing malignancy, with Thy 4 yielding 95 % malignancy and Thy 5 % 100 %. Fifty-eight patients underwent a surgical procedure for thyroid cancer. Two further patients had a diagnostic hemi-thyroidectomy for later proven benign disease. Five patients due to medical co morbidities, inoperable disease or refusal of surgery were managed non-surgically. In the surgical group 16 patients underwent a diagnostic hemi-thyroidectomy and 11 of these required a completion thyroidectomy. Forty-six patients underwent total thyroidectomy. Forty-six patients underwent a neck dissection: 27 prophylactic central compartment neck dissections and 19 planned therapeutic neck dissections were performed. Radiological staging correctly predicted final pathological TNM staging in 25 (43 %) patients. 27 (47 %) patients had radiological staging which under staged their final histological staging and 6 (10 %) patients had scans that over staged their cancer. Of those that were under staged, 15 (56 %) had their nodal disease under staged (following prophylactic central neck dissection). Radiological staging comprised ultrasound (n = 58) and CT scanning (n = 45/58 pre-operatively). Pre-operative staging in thyroid cancer should include cytology, ultrasound and CT scanning. Unless low-risk papillary thyroid cancer is suspected pre-operatively, patients with Thy 4 cytology can be given the offer of a total thyroidectomy as surgical management.

Objectives To assess how type and number of symptoms are related to survival in patients with head and neck cancer. Design Patients were followed up for over 10 years from the Scottish Audit of Head and Neck Cancer (national cohort of head and neck cancer patients in Scotland 1999‐2001). September 2013, cohort was linked to national mortality data. First, second and third presenting symptoms were recorded at diagnosis. Setting National prospective audit—Scotland. Participants A subset of 1589 patients, from the original cohort of 1895, who had cancer arising from one of the four main subsites; larynx, oropharynx, oral cavity and hypopharynx. Main outcome measures Median survival in relation to patients’ presenting symptoms. Results A total of 1146 (72%) males and 443 (28%) females, mean age at diagnosis 64 years (13‐95). There was a significant difference in survival in relation to the number of the patient's presenting symptoms; one symptom had a median survival of 5.3 years compared with 1.1 years for three symptoms. Patients who presented with weight loss had a median survival of 0.8 years, compared to 4.2 years if they did not (P < .001). Patients who presented with hoarseness had a median survival of 5.9 years compared to 2.6 years without (P < .001). There was no significant difference in long‐term survival for patients who presented with an ulcer, compared to those that did not (P = .105). Conclusions This study highlights the importance of patients’ presenting symptoms, giving valuable information in highlighting appropriate “red flag” symptoms and subsequent treatment planning and prognosis.

To meet the changing demands of consumer product form factors, there has been a steady shift to thinner and smaller semiconductor die, both of which increase the challenges for die singulation. The traditional approach of saw dicing is facing new limitations due to die damage and throughput. Compounding these issues is the finite width of saw blades, saw blade loading from clearing multiple materials, and orthogonal layout restrictions. Laser dicing has been introduced to address some of these issues, but faces other limitations such as damage from the heat affected zone, ablation residues, throughput, and material incompatibilities (changes in transparency and absorption in the street). In some cases, a combination of both saw and laser has been utilized to surmount some of the technical obstacles. The recently introduced approach of front-side plasma singulation circumvents many of the limitations of saws and lasers. The technology presented in this work uses standard dicing tape and frames, is through-wafer complete die separation, and does not involve a subsequent wafer thinning or die cleaving step. Our approach utilizes lithographically defined singulation lines with typical widths of 10–15μm, and delivers chip/crack-free edges with low-stress rounded corners. The parallel nature of this singulation method enables non-orthogonal and non-linear singulation streets allowing die layout and design flexibility not achievable by saws and/or lasers. As a consequence, plasma singulation produces increased good die per wafer through better wafer area utilization, lower die failure (reduced corner stress with rounded geometry), and flexibility in die placement near wafer edge on larger die. One of the unique advantages is that this technology can be implemented without addition of any new masking layers but instead the use of the existing passivation, metals and/or upper dielectrics as masks. Implementing this technology across a wide range of die applications such as power, memory, logic, imaging sensors, LEDs, and MEMS must address a diverse range of variables such as compatible materials, bond pads/bumps, and backmetal. For dies with backside metal, a non-etch based method to allow full die separation while the dies are still attached to tape has been demonstrated.

Injury to the larynx following intubation occurs in one-third of all patients. The national audit of the Royal College of Anaesthetists found that the larynx is the site most frequently injured (80%). 1 This may present difficult with adequate laryngeal assessment in patients undergoing microlaryngeal surgery. Trauma to intraluminal airway contents can occur. Unlike many anaesthetic challenges, this situation can be anticipated. Virtually all patients undergoing head and neck surgery have had direct flexibile laryngoscopy. As a result, many difficult situations can be pre-empted but despite this laryngeal trauma does occur. With benign laryngeal lesions, surgical outcomes are voice improvement and histological diagnosis without deterioration in voice. Iatrogenic injury to professional voice users may in time present a medicolegal challenge. 3 Patient-reported outcome measures are increasingly used following microlaryngeal surgery and are the proposed subject matter for personal audit to provide evidence for revalidation in the United Kingdom. This may have implications for the surgeon.

An earlier stage of primary disease at diagnosis is associated with better survival from laryngeal cancer. It remains unproven whether earlier stage is also associated with improved end-organ function and quality of life after treatment. Questionnaire packs were posted to 250 patients with laryngeal cancer treated between January 2006 and December 2008 within the West of Scotland. Packs contained the Voice Symptom Scale (VoiSS), MD Anderson Dysphagia Inventory (MDADI), and University of Washington Quality of Life Questionnaire (UW-QOL). One hundred forty-seven eligible patients provided data for analysis (59% of original cohort). Patients with an earlier stage of primary disease reported significantly better VoiSS, MDADI, and UW-QOL scores (p < .05). No differences were found between scores of patients with T1 laryngeal disease treated with endoscopic laser resection (ELR) and radiotherapy. An earlier stage at diagnosis is associated with significantly better end-organ function and quality of life after treatment for laryngeal cancer. © 2013 Wiley Periodicals, Inc. Head Neck, 2013.

Background\ud \ud Tonsillitis is a common condition with an incidence in UK general practice of 37 per 1000 population a year.1 Recurrent tonsillitis results in significant morbidity and impacts on individuals’ quality of life. This study assesses the morbidity and quality of life of adults with recurrent tonsillitis, and the impact of surgical intervention on their health state.\ud Objectives\ud \ud To describe disease-specific and global quality of life for adults with recurrent tonsillitis 6 months after tonsillectomy, using two instruments: the health impact of throat problems (HITP) and EuroQol-visual analogue scale questionnaire. To assess the overall health benefit from tonsillectomy as an intervention using the Glasgow Benefit Inventory (GBI). To assess potential predictors of tonsillectomy benefit.\ud Design\ud \ud A prospective, observational cohort audit of patients who have fulfilled Scottish Intercollegiate Guideline Network (SIGN) criteria for tonsillectomy.2\ud Setting\ud \ud Secondary care, teaching hospital.\ud Participants\ud \ud Seventy patients (57 female), median age 20 years (range 13-41).\ud Results\ud \ud Median preoperative HITP was 47 (range 15-67), compared to 4 (0-72), (P

Aims To carry out statistical validation of a newly developed magnetic resonance imaging (MRI) auto-contouring software tool for gross tumour volume (GTV) delineation in head and neck tumours to assist in radiotherapy planning. Materials and methods Axial MRI baseline scans were obtained for 10 oropharyngeal and laryngeal cancer patients. GTV was present on 102 axial slices and auto-contoured using the modified fuzzy c-means clustering integrated with the level set method (FCLSM). Peer-reviewed (C-gold) manual contours were used as the reference standard to validate auto-contoured GTVs (C-auto) and mean manual contours (C-manual) from two expert clinicians (C1 and C2). Multiple geometric metrics, including the Dice similarity coefficient (DSC), were used for quantitative validation. A DSC≥0.7 was deemed acceptable. Inter- and intra-variabilities among the manual contours were also validated. The two-dimensional contours were then reconstructed in three dimensions for GTV volume calculation, comparison and three-dimensional visualisation. Results The mean DSC between C-gold and C-auto was 0.79. The mean DSC between C-gold and C-manual was 0.79 and that between C1 and C2 was 0.80. The average time for GTV auto-contouring per patient was 8 min (range 6–13 min; mean 45 s per axial slice) compared with 15 min (range 6–23 min; mean 88 s per axial slice) for C1. The average volume concordance between C-gold and C-auto volumes was 86.51% compared with 74.16% between C-gold and C-manual. The average volume concordance between C1 and C2 volumes was 86.82%. Conclusions This newly designed MRI-based auto-contouring software tool shows initial acceptable results in GTV delineation of oropharyngeal and laryngeal tumours using FCLSM. This auto-contouring software tool may help reduce inter- and intra-variability and can assist clinical oncologists with time-consuming, complex radiotherapy planning.

Distributed actor languages are an effective means of constructing scalable reliable systems, and the Erlang programming language has a well-established and influential model. While the Erlang model conceptually provides reliable scalability, it has some inherent scalability limits and these force developers to depart from the model at scale. This article establishes the scalability limits of Erlang systems and reports the work of the EU RELEASE project to improve the scalability and understandability of the Erlang reliable distributed actor model. We systematically study the scalability limits of Erlang and then address the issues at the virtual machine, language, and tool levels. More specifically: (1) We have evolved the Erlang virtual machine so that it can work effectively in large-scale single-host multicore and NUMA architectures. We have made important changes and architectural improvements to the widely used Erlang/OTP release. (2) We have designed and implemented Scalable Distributed (SD) Erlang libraries to address language-level scalability issues and provided and validated a set of semantics for the new language constructs. (3) To make large Erlang systems easier to deploy, monitor, and debug, we have developed and made open source releases of five complementary tools, some specific to SD Erlang. Throughout the article we use two case studies to investigate the capabilities of our new technologies and tools: a distributed hash table based Orbit calculation and Ant Colony Optimisation (ACO). Chaos Monkey experiments show that two versions of ACO survive random process failure and hence that SD Erlang preserves the Erlang reliability model. While we report measurements on a range of NUMA and cluster architectures, the key scalability experiments are conducted on the Athos cluster with 256 hosts (6,144 cores). Even for programs with no global recovery data to maintain, SD Erlang partitions the network to reduce network traffic and hence improves performance of the Orbit and ACO benchmarks above 80 hosts. ACO measurements show that maintaining global recovery data dramatically limits scalability; however, scalability is recovered by partitioning the recovery data. We exceed the established scalability limits of distributed Erlang, and do not reach the limits of SD Erlang for these benchmarks at this scale (256 hosts, 6,144 cores).

In this paper we describe a static analyser for Java bytecode which uses a combination of amortised analysis and Separation Logic due to Robert Atkey. With the help of Java annotations we are able to give precise resource utilisation constraints for Java methods which manipulate various heap-based data structures.

The aim of this paper was to compare demographics, treatment and outcomes from two large prospective audits of head and neck cancer patients in two disparate regions of the UK.In the Scottish Audit of Head and Neck Cancer (SAHNC) a total of 1910 patients with new head and neck cancers were registered in a two year period from September 1999 to August 2001. The South and West Audit of Head and Neck Cancer (SWAHN) was carried out in three phases between 1996 and 2002 with a total of 2050 cases.There were more men in SAHNC than SWAHN (71% vs 67%, p0.01) and patients in SAHNC presented at a younger age (76% aged 45-74 compared with 64%, p0.001). Significantly more patients in Scotland had advanced (stage III/IV) laryngeal cancer (44% vs 30%, p0.001). The overall disease specific five year survival was 54.5 for SAHNC and 54.2 for SWAHN.This comparison of large head and neck cancer cohorts provides important data to base UK head and neck cancer care and hypotheses regarding pathogenesis and the effects of treatment processes. Given the heterogeneity in disease, patient and healthcare characteristics between the two regions, the similarities in survival and process outcomes are striking.

Objectives:To establish whether there is a requirement for a network policy on management of suspected intraparotid lymphoma, and to answer the question, ‘Can lymphoma of the parotid region be adequately diagnosed, typed and treated on the basis of a core biopsy, within the West of Scotland?’Method:We identified 22 patients from the West of Scotland Managed Clinical Network database who had been diagnosed between 2003 and 2005 with lymphoma of the parotid region (nodal or extranodal). These 22 cases were reviewed, assessing specifically their investigation and diagnosis (compared with the World Health Organization classification of parotid lymphoma).Results:Three of the 22 patients underwent core biopsy to diagnose and type their lymphoma. All these procedures were performed within a single centre.Conclusion:It is possible to successfully perform core biopsy of parotid lymphoma lesions (generally under ultrasonic guidance). This may obviate the need for open procedures. Close collaboration with haematology, pathology, radiology, and head and neck colleagues is required.

Introduction:Methods of perceptual voice evaluation have yet to achieve satisfactory consistency; complete acceptance of a recognised clinical protocol is still some way off.Materials and methods:Three speech and language therapists rated the voices of 43 patients attending the problem asthma clinic of a teaching hospital, according to the grade-roughness-breathiness-asthenicity-strain (GRBAS) scale and other perceptual categories.Results and analysis:Use of the GRBAS scale achieved only a 64.7 per cent inter-rater reliability and a 69.6 per cent intra-rater reliability for the grade component. One rater achieved a higher degree of consistency. Improved concordance on the GRBAS scale was observed for subjects with laryngeal abnormalities. Raters failed to reach any useful level of agreement in the other categories employed, except for perceived gender.Discussion:These results should sound a note of caution regarding routine adoption of the GRBAS scale for characterising voice quality for clinical purposes. The importance of training and the use of perceptual anchors for reliable perceptual rating need to be further investigated.

Background:Extraskeletal Ewing's sarcoma is a rare tumour of mesenchymal origin, which is histologically similar to primary osseous Ewing's sarcoma. The majority of cases have been reported in the lower limb and paravertebral region, with a few cases reported in the neck.Methods:We report a patient with extraskeletal Ewing's sarcoma presenting with a right-sided neck mass, vocal fold palsy and T1 nerve root involvement. The detection of characteristic features on computed tomography and magnetic resonance imaging scans, in conjunction with histological analysis, was required to make the diagnosis.Results:Radiological imaging demonstrated that the tumour was infiltrating through the neural exit foramina of the lower cervical nerve roots, with encasement of the vertebral artery. The patient was managed with combination chemotherapy for systemic control and irradiation for local control.Conclusion:Extraskeletal Ewing's sarcoma has a propensity to occur in a paravertebral location, being found rarely in the cervical region, and has a predilection to infiltrate through neural exit formina. Computed tomography and magnetic resonance imaging are helpful in the diagnosis of this rare tumour.

We consider the problem of adapting distributed Erlang applications to large or heterogeneous architectures to achieve good performance in a portable way. In many architectures, and especially large architectures, the communication latency between pairs of virtual machines (nodes) is no longer uniform.\ud \ud We propose two language-level methods that enable programs to automatically adapt to heterogeneity and non-uniform communication latencies, and both provide information enabling a program to identify an appropriate node when spawning a process. We provide a means of recording node attributes describing the hardware and software capabilities of nodes, and mechanisms that allow an application to examine the attributes of remote nodes. We provide an abstraction of communication distances that enables an application to select nodes to facilitate efficient communication.\ud \ud We have developed open source libraries that implement these ideas. We show that the use of attributes for node selection can lead to significant performance improvements if different components of the application have different processing requirements. We report a detailed empirical investigation of non-uniform communication times in several representative architectures, and show that our abstract model provides a good description of the hierarchy of communication times.

A new algorithm for 3D throat region segmentation from magnetic resonance imaging (MRI) is presented. The proposed algorithm initially pre-processes the MRI data to increase the contrast between the throat region and its surrounding tissues and also to reduce artifacts. Isotropic 3D volume is reconstructed using Fast Fourier Transform based interpolation. Furthermore, a cube encompassing the throat region is evolved using level set method to form a smooth 3D boundary of the throat region. The results of the proposed algorithm on real and synthetic MRI data are used to validate the robustness and accuracy of the algorithm.

Objective To determine voice outcomes in endolaryngeal surgery. Methods Prospective assessment of patients undergoing endolaryngeal surgery in one head and neck team in North Glasgow from 2007 to 2014. Each patient completed a VoiSS (the Voice Symptom Scale) questionnaire at pre-assessment and post-endolaryngeal surgery. Per-operatively, the aim of the procedure was recorded from a choice of seven options in addition to the clinical conditions and the procedure. Results One thousand and sixty-six patient episodes were recorded. Thirty-two had incomplete data at pre-assessment and were excluded. Of the remainder, 703 (68%) had complete paired data sets. 'To improve voice' (n = 169, 24%) and 'to achieve a biopsy with no deterioration in voice' (n = 185, 26%) categories had significant outcomes in keeping with the operative aims. Conclusion This study demonstrated that it is possible to assess patient reported voice outcomes in universal heterogeneous endolaryngeal surgery cohort over a prolonged period. The voice outcomes were in keeping with the stated aims of the endolaryngeal surgical procedures.

We explore optimization strategies and resulting performance of two stream-based video applications, video texture and color tracker, on a cluster of SMPs. The two applications are representative of a class of emerging applications, which we call ''stream-based applications'', that are sensitive to both latency of individual results and overall throughput. Such applications require non-trivial parallelization techniques in order to improve both latency and throughput, given that the stream data emanates from a limited set of sources (exactly one in the two applications studied) and that the distribution of the data cannot be done a priori. We suggest techniques that address in a coordinated fashion the problems of data distribution and work partitioning. We believe the two problems are related and need to be addressed together. We have parallelized two applications using the Stampede cluster programming system that provides abstractions for implementing time- and throughput-sensitive applications elegantly and efficiently. For the Video Textures application we show that we can achieve a speedup of 24.26 on a 112 processor cluster. For the Color Tracker application, where latency is more crucial, we identify the extent of data parallelism that ensures that the slowest member of the pipeline is no longer the bottleneck for achieving a decent frame rate.

Within a year of the Blair Government taking office, Bagehot in The Economist (1998) was accusing them of presiding over ‘a frenzy of constitutional reform” which needed “to be underpinned by some unifying political vision’. This article describes how that situation came about; and surveys briefly how the constitutional reform programme has developed in the meantime. It concludes that the Government still shows little appetite for contemplating or presenting constitutional change in the round and finds some of the consequences of its own reforms to be a source of embarrassment or frustration. Nevertheless they have transformed the landscape of governance beyond recognition and in some aspects, irrevocably and their achievements in this area seem likely to be a significant part of their monument as an administration.

Objective Short, self-report symptom questionnaires are useful in routine clinical situations for assessing the progress of disorders and the influence of interventions. The Voice Handicap Index-10 (VHI-10) and Vocal Performance Questionnaire (VPQ) are brief self-reported assessments of voice pathology, apparently useful in the general voice clinic population. Little is known of the structure or internal consistency of either tool, nor whether they correlate. This study carried out a substantial, systematic evaluation of their performance in the Laryngology office setting. Study design and setting 330 adult (222 women, 108 men) voice clinic attenders completed the VHI and the VPQ. RESULTS: The VHI-10 and VPQ each had a large, single principal component, high internal consistency, and were highly correlated (disattenuated r=0.91). Conclusion The VHI-10 and the VPQ are similar, short, convenient, internally-consistent, unidimensional tools. Significance The total VHI-10 or VPQ score is a good overall indicator of the severity of voice disorders.

Emerging application domains such as interactive vision, animation, and multimedia collaboration display dynamic scalable parallelism and high-computational requirements, making them good candidates for executing on parallel architectures such as SMPs and clusters of SMPs. Stampede is a programming system that has many of the needed functionalities such as high-level data sharing, dynamic cluster-wide threads and their synchronization, support for task and data parallelism, handling of time-sequenced data items, and automatic buffer management. We present an overview of Stampede, the primary data abstractions, the algorithmic basis of garbage collection, and the issues in implementing these abstractions on a cluster of SMPs. We also present a set of micromeasurements along with two multimedia applications implemented on top of Stampede, through which we demonstrate the low overhead of this runtime and that it is suitable for the streaming multimedia applications.

In Robert Louis Stevenson's novel[31], Dr Jekyll is a well-regarded member of polite society, while his alter ego Mr Hyde shares the same physical form but roams abroad communing with the lowest elements. In this paper we present Grail, a well-behaved first-order functional language that is the target for an ML-like compiler; while also being a wholly imperative language of assignments that travels and executes as Java classfiles. We use this dual identity in the Mobile Resource Guarantees project, where Grail serves as proof-carrying code to provide assurances of time and space performance, thereby supporting secure and reliable global computing.This work was performed as part of the Mobile Resource Guarantees project, funded by the European Commission under the Fifth Framework's proactive initiative on Global Computing, IST-2001-33149. In addition, Ian Stark is funded by an EPSRC Advanced Research Fellowship in Mathematical Models for Concurrent and Mobile Computation, GR/R76950/01. We would like to thank all MRG members for the numerous discussions on Grail and Nicholas Wolverson for his help with the implementation of the compilers.

Objective: Many voice-rating tools are either physician-derived, disease-specific measures or they merely combine general quality-of-life domains with vocal symptoms. The aim of this series of studies was to devise and validate a patient-derived inventory of voice symptoms for use as a sensitive assessment tool of (i) baseline pathology and (ii) response to change in adult dysphonia clinics. Method: Three stages in the development of the instrument are described. First, an initial exploratory, open-ended questionnaire study was used to compile a prototype list of voice complaints [Clin Otolaryngol 22 (1997) 37]. Second, the prototype list was administered to 168 subjects with dysphonia and underwent principal components analysis. Qualitatively, it was also assessed at this stage for its ability to capture voice-related impairment, disability and handicap. Third, a modified 44-item scale was administered to 180 new subjects. Results: The symptoms were highly endorsed. Principal components analysis with oblique rotation yielded a Voice Symptom Scale (VoiSS); 43 of the items comprise a ‘general voice pathology’ scale. More specifically, five oblique components provided assessments of: ‘communication problems,’ ‘throat infections,’ ‘psychosocial distress,’ ‘voice sound and variability’ and ‘phlegm.’ Conclusion: The VoiSS is simple for patients to complete and easy to score. It is sensitive enough to reflect the wide range of communication, physical symptoms and emotional responses implicit in adult dysphonia.

In support of improved productivity for the semiconductor and optoelectronics manufacturing industry, new work is presented on the development of a plasma-based die singulation process technique for thin Si wafers. It is shown that the technique leads to a significant gain in productivity through reduced process times and increased available good die per wafer. Some additional related key benefits are increased yield, die strength, and the potential of nonorthogonal die.

The barriers for implementing an Intelligent Energy (IE) Solution can vary from asset to asset. To complicate matters further, the challenges are extremely diverse ranging from organizational to technical. Quantifying the challenges requires discovering the gaps between the asset’s current state and the state required for the solution. Leadership commitment, effective workflow modeling, data quality and user’s behavioral change are examples of the kinds of gaps that could result in a delayed or potentially failed implementation. A key component is to identify the gaps early enough to ensure the asset has the time to allocate resources and close the gaps prior to deploying the solution. The potential exists that once the asset truly understands the time, effort and resources required the business case may no longer justify the implementation for that asset. While this may appear to be a negative it actually results in the ability to improve business decisions. To ensure a successful IE Solution Deployment and understand the true business value, processes to uncover and address the gaps between the asset’s current state and the state required for the solution is critical. In an effort to tackle the IE Solution implementation challenges, Chevron’s Upstream Workflow Transformation Team has developed processes to identify and address the barriers. These processes have been piloted and adopted as standards for implementing IE Solutions.

Dysphonia (hoarseness) is a common clinical condition and, if persistent, patients are referred to otolaryngology clinics for clinical examination. During the examination, a clinical distinction is often made among three types of patients: (1) those with a clear organic basis for dysphonia (cancer, vocal cord palsy): (2) those with some degree of organic pathology; and (3) those with an apparently functional etiology. Functional patients are often characterized as having a psychogenic disorder. This study assessed the psychological validity of the functional category in 204 out-patients (aged 17 to 87 years) with persistent hoarseness of types (2) and (3). Following clinical examination, a consultant otolaryngologist categorized patients as having functional or organic etiology. Subjects were then compared on measures of personality and psychological distress. Dysphonic subjects showed marked psychological distress compared with norms, and reported significantly more previous psychosomatic symptoms than norms, but there were no differences in personality or psychological distress between organic and functional subgroups of dysphonics.

A variety of models for parallel architectures, such as shared memory, message passing, and data flow, have converged in the recent past to a hybrid architecture form called distributed shared memory (DSM). Alewife, an early prototype of such DSM architectures, uses hybrid software and hardware mechanisms to support coherent shared memory, efficient user level messaging, fine grain synchronization, and latency tolerance. Alewife supports up to 512 processing nodes connected over a scalable and cost effective mesh network at a constant cost per node. Four mechanisms combine to achieve Alewife's goals of scalability and programmability: software extended coherent shared memory provides a global, linear address space; integrated message passing allows compiler and operating system designers to provide efficient communication and synchronization; support for fine grain computation allows many processors to cooperate on small problem sizes; and latency tolerance mechanisms-including block multithreading and prefetching-mask unavoidable delays due to communication. Extensive results from microbenchmarks, together with over a dozen complete applications running on a 32-node prototype, demonstrate that integrating message passing with shared memory enables a cost efficient solution to the cache coherence problem and provides a rich set of programming primitives. Our results further show that messaging and shared memory operations are both important because each helps the programmer to achieve the best performance for various machine configurations.

Following apparent subacute thyroiditis, a 16-year-old girl developed a left thyroid abscess thought to be secondary to steroids and haematogenous spread from a pilonidal abscess. The thyroid suppuration became recurrent and required partial thyroidectomy. Further left-sided abscess formation in the neck prompted a barium swallow which revealed the source of infection to be a sinus tract arising from the left piriform fossa. The patent fourth branchial sinus tract was later excised. All patients with a tender thyroid should have ultrasound-guided fine needle aspiration to establish the diagnosis. If suppuration is confirmed, a barium swallow is advised to exclude a sinus tract from the piriform fossa.