The clinical characteristics of benign oral mucosal tumors

Objectives: To investigate the clinical characteristics and pre-biopsy provisional diagnoses of benign oral mucosal tumors. Material and Methods: A 10- year retrospective analysis of all benign tumors of the oral mucosa, from a univer- Methods: A 10- year retrospective analysis of all benign tumors of the oral mucosa, from a univer - sity- affiliated oral and maxillofacial surgery department. Results: 146 benign tumors were included. The mean age was 49.6 years, with an approximately equal gender dis - tribution. The most prevalent tumor types were lipomatous tumors (27.4%), vascular (23.3%), and salivary gland tumors (16.5%). Tongue, labial and buccal mucosa were the most frequently involved sites. The vast majority (98.6%) presented as non-ulcerated masses. Only 2 (1.4%) presented as ulcerated masses. The clinical provisional diagnosis correctly classified lesions as non-malignant in 93.3%. In only 9 (6.7%) suspicion of malignancy was in - cluded in the provisional diagnosis. However, benign neoplasia was unsuspected in 42.1% of tumors. These cases were clinically classified as reactive. Conclusions: Benign tumors were most likely to be clinically correctly classified as non-malignant, but even in the setting of experienced oral surgeons, neoplasia was unsuspected in more than 40% of cases. This data strongly supports the need to biopsy every oral mucosal mass, since inaccurate clinical evaluation of the lesion's biological nature was a frequent event

Is Routine Multivitamin Supplementation Necessary in US Chronic Adult Hemodialysis Patients? A Systematic Review

Because of concern that United States (US) chronic hemodialysis patients are at high risk for the development of vitamin deficiencies, the great majority of such patients are routinely supplemented with a multivitamin. This policy is supported by major US dialysis providers and nonprofit organizations. Yet routine multivitamin supplementation expands hemodialysis patients' already large pill burden, probably accounts for many millions of dollars in annual costs, and in light of previous reports may even carry with it the possibility of increased risk of adverse outcomes. An analysis of the benefits of routine multivitamin supplementation in US patients is therefore in order. We performed a systematic review of the medical literature between 1970 and 2014 using the Ovid MEDLINE database to address this question. We conclude that there is insufficient evidence to support routine multivitamin use and recommend that the decision to supplement be made on an individual basis

The Peculiar Phase Structure of Random Graph Bisection

The mincut graph bisection problem involves partitioning the n vertices of a graph into disjoint subsets, each containing exactly n/2 vertices, while minimizing the number of "cut" edges with an endpoint in each subset. When considered over sparse random graphs, the phase structure of the graph bisection problem displays certain familiar properties, but also some surprises. It is known that when the mean degree is below the critical value of 2 log 2, the cutsize is zero with high probability. We study how the minimum cutsize increases with mean degree above this critical threshold, finding a new analytical upper bound that improves considerably upon previous bounds. Combined with recent results on expander graphs, our bound suggests the unusual scenario that random graph bisection is replica symmetric up to and beyond the critical threshold, with a replica symmetry breaking transition possibly taking place above the threshold. An intriguing algorithmic consequence is that although the problem is NP-hard, we can find near-optimal cutsizes (whose ratio to the optimal value approaches 1 asymptotically) in polynomial time for typical instances near the phase transition.Comment: substantially revised section 2, changed figures 3, 4 and 6, made minor stylistic changes and added reference

Extremal Optimization at the Phase Transition of the 3-Coloring Problem

We investigate the phase transition of the 3-coloring problem on random graphs, using the extremal optimization heuristic. 3-coloring is among the hardest combinatorial optimization problems and is closely related to a 3-state anti-ferromagnetic Potts model. Like many other such optimization problems, it has been shown to exhibit a phase transition in its ground state behavior under variation of a system parameter: the graph's mean vertex degree. This phase transition is often associated with the instances of highest complexity. We use extremal optimization to measure the ground state cost and the ``backbone'', an order parameter related to ground state overlap, averaged over a large number of instances near the transition for random graphs of size $n$ up to 512. For graphs up to this size, benchmarks show that extremal optimization reaches ground states and explores a sufficient number of them to give the correct backbone value after about $O(n^{3.5})$ update steps. Finite size scaling gives a critical mean degree value $\alpha_{\rm c}=4.703(28)$. Furthermore, the exploration of the degenerate ground states indicates that the backbone order parameter, measuring the constrainedness of the problem, exhibits a first-order phase transition.Comment: RevTex4, 8 pages, 4 postscript figures, related information available at http://www.physics.emory.edu/faculty/boettcher

Extremal Optimization for Graph Partitioning

Extremal optimization is a new general-purpose method for approximating solutions to hard optimization problems. We study the method in detail by way of the NP-hard graph partitioning problem. We discuss the scaling behavior of extremal optimization, focusing on the convergence of the average run as a function of runtime and system size. The method has a single free parameter, which we determine numerically and justify using a simple argument. Our numerical results demonstrate that on random graphs, extremal optimization maintains consistent accuracy for increasing system sizes, with an approximation error decreasing over runtime roughly as a power law t^(-0.4). On geometrically structured graphs, the scaling of results from the average run suggests that these are far from optimal, with large fluctuations between individual trials. But when only the best runs are considered, results consistent with theoretical arguments are recovered.Comment: 34 pages, RevTex4, 1 table and 20 ps-figures included, related papers available at http://www.physics.emory.edu/faculty/boettcher

Price and service competition with maintenance service bundling

In many equipment manufacturing industries, firms compete with each other not only on products price, but also on maintenance service. More and more traditional products oriented firms are offering their customers products bundled with maintenance service (P&S bundles). In this study, we examine firms’ incentive to offer customers products bundling with long-term maintenance or repair support service in a duopoly competitive environment. When providing P&S bundles, a firm need to determine the service level (in terms of average response time guarantee for the service in this paper) to offer and needs to build a service facility to handle the maintenance service requirements. Based on the analysis of three sub-game models, we characterize the market conditions in which only one firm, both firms or neither firm will offer P&S bundles. Finally, we analyze the affects of several market factors on firms’ strategy choices

A comparison between Asian and Australasia backpackers using cultural consensus analysis

This study tests the differences in the shared understanding of the backpacker cultural domain between two groups: backpackers from Australasia and backpackers from Asian countries. A total of 256 backpackers responded to a questionnaire administered in Kuala Lumpur, Bangkok and Krabi Province (Thailand). Cultural consensus analysis (CCA) guided the data analysis, to identify the shared values and the differences in the backpacker culture of the two groups. The findings revealed that while the two groups share some of the backpacker cultural values, some other values are distinctively different from one another. The study provides the first empirical evidence of the differences in backpacking culture between the two groups using CCA. Based on the study findings, we propose some marketing and managerial implications

Cell-to-cell variability of alternative RNA splicing

The role of mRNA processing in gene expression variability is poorly characterized. This study investigates the extent of cell-to-cell variability of alternative RNA splicing in mammalian cells using single-molecule imaging of CAPRIN1 and MKNK2 splice isoforms

Chronic kidney disease and arrhythmias: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.

Patients with chronic kidney disease (CKD) are predisposed to heart rhythm disorders, including atrial fibrillation (AF)/atrial flutter, supraventricular tachycardias, ventricular arrhythmias, and sudden cardiac death (SCD). While treatment options, including drug, device, and procedural therapies, are available, their use in the setting of CKD is complex and limited. Patients with CKD and end-stage kidney disease (ESKD) have historically been under-represented or excluded from randomized trials of arrhythmia treatment strategies,1 although this situation is changing.2 Cardiovascular society consensus documents have recently identified evidence gaps for treating patients with CKD and heart rhythm disorders [...