Background: About five to 10% of cancers in the head and neck region are neck squamous cell carcinoma of unknown primary (NSCCUP). Their diagnosis and treatment are challenging given the risk of missing occult tumors and potential relapse. Recently, we described human papillomavirus (HPV)-related NSCCUP-patients (NSCCUP-P) as a subgroup with superior survival. However, standardized diagnostic workup, novel diagnostic procedures, decision-making in the multidisciplinary tumor board (MDTB) and multimodal therapy including surgery and post-operative radio-chemotherapy (PORCT) may also improve survival. Methods: For assessing the impact of standardized diagnostic processes simultaneously established with the MDTB on outcome, we split our sample of 115 NSCCUP-P into two cohorts treated with curative intent from 1988 to 2006 (cohort 1; n = 53) and 2007 to 2018 (cohort 2; n = 62). We compared diagnostic processes and utilized treatment modalities applying Chi-square tests, and outcome by Kaplan–Meier plots and Cox regression. Results: In cohort 2, the standardized processes (regular use of [18F]-FDG-PET-CT imaging followed by examination under anesthesia, EUA, bilateral tonsillectomy and neck dissection, ND, at least of the affected site) improved detection of primaries (P = 0.026) mostly located in the oropharynx (P = 0.001). From 66.0 to 87.1% increased ND frequency (P = 0.007) increased the detection of extracapsular extension of neck nodes (ECE+) forcing risk factor-adapted treatment by increased utilization of cisplatin-based PORCT that improved 5-years progression-free and overall survival from 60.4 and 45.3 to 67.7% (P = 0.411) and 66.1% (P = 0.025). Conclusions: Standardized diagnostic workup followed by ND and risk-factor adapted therapy improves survival of NSCCUP-P.

No description available.

The widespread availability of image editing tools and improvements in image processing techniques make image manipulation feasible for the general population. Oftentimes, easy-to-use yet sophisticated image editing tools produce results that contain modifications imperceptible to the human observer. Distribution of forged images can have drastic ramifications, especially when coupled with the speed and vastness of the Internet. Therefore, verifying image integrity poses an immense and important challenge to the digital forensic community. Satellite images specifically can be modified in a number of ways, such as inserting objects into an image to hide existing scenes and structures. In this thesis, we describe the use of a Conditional Generative Adversarial Network (cGAN) to identify the presence of such spliced forgeries within satellite images. Additionally, we identify their locations and shapes. Trained on pristine and falsified images, our method achieves high success on these detection and localization objectives.

It is a major clinical problem that survival rates after out-of-hospital cardiac arrest have not markedly improved during the last decades, despite extensive research and the introduction of new interventions. However, recent studies have demonstrated promising treatments such as targeted temperature management (TTM) and methylene blue (MB). In our first study, we investigated the effect of MB administered during experi-mental cardiopulmonary resuscitation (CPR) in the setting of postponed hypother-mia in piglets. We set out to study if MB could compensate for a delay to establish targeted TTM. The study demonstrated that MB more than compensated for 30 min delay in induction of TTM. The effect of MB added to that of TTM. The second study examined the effects of TTM and S-PBN on the endothelin system and nitric oxide synthases (NOS) after prolonged CA in a porcine CPR mod-el. The study was designed to understand the cardioprotective mechanism of S-PBN and TTM by their influence on the endothelin system and NOS regulation. We veri-fied for the first time, that these two cardioprotective postresuscitative interventions activate endothelin-1 and its receptors concomitantly with eNOS and nNOS in the myocardium. We concluded that nitric oxide and endothelin pathways are implicated in the postresuscitative cardioprotective effects of TTM. The third study compared survival and hemodynamic effects of low-dose amio-darone and vasopressin to vasopressin in a porcine hypovolemic CA model. The study was designed to evaluate whether resuscitation with amiodarone and vasopressin compared to vasopressin alone would have an impact on resuscitation success, survival, and hemodynamic parameters after hemorrhagic CA. We found that combined resuscitation with amiodarone and vasopressin after hemorrhagic circulatory arrest resulted in greater 3-hour survival, better preserved hemodynamic parameters and smaller myocardial injury compared to resuscitation with vasopressin only. In our fourth study we planned to compare hemodynamic parameters between the treatment group (milrinone, esmolol and vasopressin; MEV) and control group (vasopressin only) during resuscitation from prolonged cardiac arrest in piglets. The study was designed to demonstrate if MEV treatment improved hemodynamics or cardiac damage compared to controls. We demonstrated that MEV treatment reduced cardiac injury compared with vasopressin alone.

Abstract in English, Afrikaans and Zulu / The fostering of self-regulation is of great importance in the Early Childhood Development (ECD) phase, because it leads to future self-discipline. The aim of the study was to understand the participants’ ways of fostering self-regulation during free play in three primary schools in Zimbabwe. The theoretical frameworks of the study, namely positive psychology and Deci and Ryan’s Self-Determination Theory (SDT), as well as the Basic Psychological Needs Theory (BPNT), regarded the learners’ support for autonomy, competence and relatedness as key characteristics of positive discipline that support the development of self-regulation. Benner’s interpretive phenomenology method was used with the aim of describing and interpreting participants’ experiences of the phenomenon under study. The social constructivism paradigm underpinned the study and the approach was qualitative. Data collection and analysis were guided by Benner’s interpretive phenomenological method. A paradigm case, themes and exemplars were used in data presentation, discussion and interpretation. Findings showed that free-play activities consisted of, for instance, socio-dramatic play, indoor play in play corners and outdoor play. The common practices used by the participants to foster self-regulation through positive discipline were co-regulation, positive reinforcement, time-out and logical consequences. Teachers and learners often perceived the teachers’ use of time-out and logical consequences as punishment rather than positive discipline, because of the rigidity of its application without considering psychosocial needs. The findings, however, were consistent with an understanding of fostering self-regulation through positive discipline during free play by nurturing the learners’ psychological needs for autonomy, competence and relatedness, as well as mindfulness. Research proposed mindfulness as a possible fourth basic psychological need. In line with the Sustainable Development Goals (SDGs) for achieving a better and sustainable future for all people by 2030, participants perceived the fostering of self-regulation through positive discipline as part of gender education for eradicating gender-based violence and to foster resilience. / Selfregulering moet in die vroeë kinderjare reeds by klein kinders gekweek word sodat hulle later in die lewe in staat sal wees om selfdissipline aan die dag te lê. Die doel van hierdie studie was om vas te stel hoe die deelnemers by drie laerskole in Zimbabwe gedurende vrye spel selfregulering by leerders gekweek het. Die drie teoretiese raamwerke waarop hierdie studie berus, is die positiewe sielkunde, Deci en Ryan se selfbeskikkingsteorie (SBT) en die teorie van basiese psigososiale behoeftes (TBSB). Hiervolgens is die bevrediging van kinders se behoefte aan outonomie, bedrewenheid (‘competence’) en verhoudings (‘relatedness’) voorvereistes vir die positiewe dissiplinering waarmee selfregulering by hulle gekweek word. Benner se metode van interpretatiewe fenomenologie is gevolg om deelnemers se belewing van die fenomeen te beskryf en te vertolk. Die sosiale konstruktivisme het die grondslag van hierdie studie gevorm, en die benadering was kwalitatief. Data is volgens Benner se metode van interpretatiewe fenomenologie ingewin en ontleed. ʼn Paradigmageval, temas en voorbeelde (‘exemplars’) is in die aanbieding, bespreking en interpretasie van data gebruik. Volgens die bevindings het vryespelaktiwiteite bestaan uit onder meer sosiaal-dramatiese spel, binnenshuise spel in speelhoekies, en buitelugspel. Die praktyke waarvolgens deelnemers selfregulering deur positiewe dissiplinering gekweek het, was onderlinge regulering, positiewe versterking, afkoeltyd en logiese gevolge. Onderwysers en leerders het afkoeltyd en logiese gevolge nie as positiewe dissiplinering nie, maar eerder as straf belewe aangesien dit streng toegepas word en nie met die kind se psigososiale behoeftes rekening hou nie. Die bevindings strook egter met ons siening van die kweek van selfregulering deur positiewe dissiplinering tydens vrye spel deur leerders se psigososiale behoefte aan outonomie, bedrewenheid (‘comptetence’), verhoudings (‘relatedness’) en bewustheid (‘mindfulness’) te bevredig. Navorsers stel bewustheid (‘mindfulness’) as ʼn vierde basiese psigososiale behoefte voor. In ooreenstemming met die Doelwitte vir Volhoubare Ontwikkeling (DVO’s) vir ʼn beter en volhoubare toekoms vir alle mense teen 2030, het deelnemers gevind dat die kweek van selfregulering deur positiewe dissiplinering deel uitmaak van genderopvoeding as teenvoeter vir geslagsgeweld, en vindingrykheid aanwakker. / Ukukhuthaza ukuzilawula kubaluleke kakhulu esigabeni sokuThuthukiswa Kwabantwana Abasebancane (i-ECD phase), ngoba kuholela ekuzikhalimeni esikhathini esizayo. Inhloso yalolu cwaningo bekuwukuqonda izindlela zababambiqhaza zokukhuthaza ukuzilawula ngesikhathi sokudlala ngokukhululeka ezikoleni ezintathu zamabanga aphansi eZimbabwe. Izinhlaka zombono wezinzululwazi zalolu cwaningo, ezaziwa ngokuthi okuhle kwengqondo kanye noMbono Wenzululwazi kaDeci noRyan Wokuzimisela (i-SDT), kanye noMbono Wenzululwazi Wezidingo Eziyisisekelo Zokuphathelene Nenggqondo (i-BPNT), zithathe ukwesekwa kwabafundi njengokuzimele, ikhono kanye nokuhlobana njengezimpawu ezisemqoka zokukwazi ukuzikhalima okuhle okusekela ukuthuthukiswa kokuzilawula. Kusetshenziswe indlela kaBenner yokuhumusha okwenzekile ngenhloso yokuchaza nokuhumusha okwenzeke kubabambiqhaza kulokho okufundwa ngako. Inqubo yokwakhiwa kwezenhlalakahle iyona esekele ucwaningo kanti futhi indlela yokwenza ibibheka amaqiniso. Ukuqoqwa kwemininingo nokuhlaziywa bekuncike endleleni kaBenner yokuhumusha okwenzekile. Kwasetshenziswa izimo semiqondo, izingqikithi kanye nezibonelo ukwethula imininingo, izingxoxo nokuhumusha. Okutholakele kukhombisile ukuthi ukudlala ngokukhululeka kubandakanya, ngokwesibonelo, ukudlala ngokulingisa ezenhlalo, ukudlala endlini emakhoneni okudlala kanye nokudlala ngaphandle. Imikhuba ejwayelekile esetshenziswa ngababambiqhaza ukukhuthaza ukuzilawula ngokusebenzisa ukukhalima okukahle kwakungukulawula ngokubambisana, ukukhuthaza okuhle, ukuqedwa komdlalo kanye nemiphumela eyenza umqondo. Othisha nabafundi babevame ukubona ukuqedwa komdlalo nemiphumela eyenza umqondo njengento esetshenziswa ngothisha njengesijeziso kunokukhalima okuhle, ngenxa yobukhuni bokusetshenziswa kwako ngaphandle kokubheka izidingo zomqondo. Okutholakele, nokho, bekuhambisana nokuqonda kokukhuthaza ukuzilawula ngokukhalima okukahle ngesikhathi sokudlala ngokukhululeka ngokunakekela izidingo zabafundi zokuphathelene nengqondo ekuzimeleni, ikhono kanye nokuhlobana, kanye nokuqaphela izinto. Ucwaningo luhlongoze ukuqaphela izinto njengesidingo sesine esiyisisekelo kokuphathelene nengqondo. Ngokuhambisanayo neziNjongo Zokuthuthukiswa Okusinokusimama (ama-SDG) ukuze kufezeke ikusasa elingcono nelinokusimama kubantu bonke ngonyaka ka- 2030, ababambiqhaza babona ukukhuthaza ukuzilawula ngokuzikhalima okukahle njengengxenye yemfundo yobulili ukuze kuncishiswe udlame oluncike ebulilini futhi kukhuthazwe ukuqina. / Psychology of Education / D. Ed. (Psychology of Education)