Node Groups Research Articles

Lymph node metastatic patterns and the development of multidisciplinary treatment for esophageal cancer.

Abundant lymphatic flow and the anatomical location of the esophagus can result in the widespread distribution of lymph node metastasis of esophageal cancer from the cervical to the abdominal field. Historically, the Japan Esophageal Society and American Joint Committee on Cancer offer two different classifications of lymph node group location surrounding the esophagus. The location of sentinel lymph nodes in midthoracic esophageal cancer reflects the variety of lymphatic drainage routes. In fact, in cT1N0 esophageal cancer, pathological lymph node metastasis has been observed from the cervical to the abdominal field, and the locations were shown to be closely linked to the primary tumor location in advanced stages. While the impact of histology on the distribution of LN metastasis has been extensively debated, a recent prospective study on esophagogastric junction cancer found that metastatic patterns did not differ by histology. Thoracic duct lymph nodes were defined as one of the regional lymph node stations in the mediastinum. Although lymph node metastasis around the thoracic duct has occasionally been observed, the oncologic impact of thoracic duct lymph node dissection has not been fully elucidated. To eradicate tumors locoregionally, three-field lymph node dissection, a strategy for extended lymph node clearance, has been established. In esophagectomy, three-field lymph node dissection is defined as a procedure for complete regional cervico-thoraco-abdominal lymph node dissection. However, its therapeutic efficacy must be evaluated based on the balance between oncological outcomes and possible added surgical risk. To further improve survival, multidisciplinary treatment consisting of surgery, chemotherapy, and radiotherapy has been established worldwide as a standard treatment for esophageal cancer. Now that neoadjuvant therapy followed by esophagectomy is the standard, adding adjuvant therapy including immunotherapy could be a promising treatment option. The ideal combination of various multidisciplinary treatment approaches and extensive LN dissection need to be established to improve the oncological outcomes for EC patients.

Whole‑body MRI for metastatic workup in patients diagnosed with cancer.

Early diagnosis and appropriate staging workup are crucial for cancer patients. Whole-body magnetic resonance imaging (WB-MRI) has been proposed as another practical whole-body approach for assessing local invasiveness and distant metastases in patients newly diagnosed with cancer. The current study aimed to evaluate the efficacy of WB-MRI in assessing metastasis in patients newly diagnosed with cancer using histopathologic data as the reference method. A prospective observational study was performed from April 2018 to July 2020. MRI sequences were utilized to acquire anatomical and functional images in three orthogonal planes. The discovery was classified as nodal, skeletal and visceral metastases. Patient-based analysis was used for visceral metastasis and region-based for skeletal, systemic and lymph node metastases. A total of 43 consecutive patients (mean age, 56±15.2 years) were assessed successively. In 41 patients, there was a concordance between the WB-MRI and histological confirmation. The most prevalent site of metastasis was the skeletal system (18 patients). There were 12 individuals with liver metastasis, 10 with lung metastasis and 4 with peritoneal metastasis, with just one brain metastatic lesion found. On WB-MRI, 38 lymph node groups were deemed positive. Out of the total, 66 skeletal locations contained metastases. The accuracy of WB-MRI for nodal, skeletal and visceral metastases was (98.45, 100 and 100%, respectively). In conclusion, WB-MRI in three orthogonal planes, including the diffusion-weighted MRI with background body signal suppression sequence, may be utilized efficiently and accurately for assessing metastasis staging and may thus be utilized in patients with newly diagnosed cancer.

The Outcomes of Balanced Orbital Decompression for Dysthyroid Optic Neuropathy: Focusing on Choroiretinal Folds with and without Optic Disc Edema.

To assess the outcomes of balanced orbital decompression for chorioretinal folds (CRFs) with and without optic disc edema (ODE) in dysthyroid optic neuropathy (DON). A retrospective, interventional study was performed at Sun Yat-sen Memorial Hospital from April 2018 to November 2021. We collected the medical records of 13 patients (24 eyes) with DON and CRFs. Then, we divided them into the ODE group (15 eyes, 62.5%) and the non-ODE group (NODE group, 9 eyes, 37.5%). The valid ophthalmic examination parameters of 8 eyes in each group after balanced orbital decompression were compared at the 6-month follow-up. The mean best corrected visual acuity (BCVA, 0.29 ± 0.27) and visual field-mean deviation (VF-MD, -6.55 ± 3.71 dB) in the ODE group were significantly worse than those in the NODE group (0.06 ± 0.15 and -3.49 ± 1.56 dB; all p < 0.01). Six months after orbital decompression, all parameters were found to have significantly improved in both groups, including BCVA and VF-MD (all p < 0.05). Moreover, the improvement amplitude of BCVA (p = 0.020) in the ODE group was significantly greater than that in the NODE group. There was no difference in BCVA between the ODE group (0.13 ± 0.19) and the NODE group (0.10 ± 0.13). The disc edema of all eyes (8/8 eyes, 100%) in the ODE group was completely mitigated after orbital decompression. The CRF resolution of 2 eyes (2/8 eyes, 25%) in the ODE group and no eyes in the NODE group was mitigated. Balanced orbital decompression can significantly improve visual functions and eliminate optic disc edema in DON patients, whether CRF relieves or not.

Medial retropharyngeal nodal region sparing radiotherapy versus standard radiotherapy in patients with nasopharyngeal carcinoma: open label, non-inferiority, multicentre, randomised, phase 3 trial

ObjectivesTo address whether sparing the medial retropharyngeal lymph node (MRLN) region from elective irradiation volume provides non-inferior local relapse-free survival versus standard radiotherapy in patients with nasopharyngeal carcinoma.DesignOpen-label, non-inferiority, multicentre,...

Preliminary study on CT contrast-enhanced radiomics for predicting central cervical lymph node status in patients with thyroid nodules.

To explore the feasibility of using a contrast-enhanced CT image-based radiomics model to predict central cervical lymph node status in patients with thyroid nodules. Pretreatment clinical and CT imaging data from 271 patients with surgically diagnosed and treated thyroid nodules were retrospectively analyzed. According to the pathological features of the thyroid nodules and central lymph nodes, the patients were divided into three groups: group 1: papillary thyroid carcinoma (PTC) metastatic lymph node group; group 2: PTC nonmetastatic lymph node group; and group 3: benign thyroid nodule reactive lymph node group. Radiomics models were constructed to compare the three groups by pairwise classification (model 1: group 1 vs group 3; model 2: group 1 vs group 2; model 3: group 2 vs group 3; and model 4: group 1 vs groups (2 + 3)). The feature parameters with good generalizability and clinical risk factors were screened. A nomogram was constructed by combining the radiomics features and clinical risk factors. Receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were performed to assess the diagnostic and clinical value of the nomogram. For radiomics models 1, 2, and 3, the areas under the curve (AUCs) in the training group were 0.97, 0.96, and 0.93, respectively. The following independent clinical risk factors were identified: model 1, arterial phase CT values; model 2, sex and arterial phase CT values; model 3: none. The AUCs for the nomograms of models 1 and 2 in the training group were 0.98 and 0.97, respectively, and those in the test group were 0.95 and 0.87, respectively. The AUCs of the model 4 nomogram in the training and test groups were 0.96 and 0.94, respectively. Calibration curve analysis and DCA revealed the high clinical value of the nomograms of models 1, 2 and 4. The nomograms based on contrast-enhanced CT images had good predictive efficacy in classifying benign and malignant central cervical lymph nodes of thyroid nodule patients.

Effect of Calcified Lymph Nodes on Thoracoscopic Lobectomy in Chronic Obstructive Pulmonary Disease Patients with Lung Cancer

Objective To observe the effect of calcified lymph nodes on video-assisted thoracoscopic surgery (VATS) lobectomy in the chronic obstructive pulmonary disease (COPD) patients with lung cancer. Methods A retrospective analysis was conducted on the COPD patients with lung cancer who underwent VATS lobectomy in the Department of Thoracic Surgery in the First Affiliated Hospital of Hebei North University from May 2014 to May 2018.The patients were assigned into a calcified lymph node group and a control group according to the presence or absence of calcified lymph nodes in CT,and the size,morphology,and calcification degree of the lymph nodes were recorded.The operation duration,intraoperative blood loss,chest tube retention time,hospitalization days,and overall complication rate were compared between the two groups. Results The 30 patients in the calcified lymph node group included 17 patients with one calcified lymph node and 13 patients with two or more calcified lymph nodes,and a total of 65 calcified lymph nodes were recorded.The calcified lymph nodes with the size ≤5 mm were the most common (53.8%),and complete calcification was the most common form (55.4%) in lymph node calcification.The mean operation duration had no significant difference between the calcified lymph node group and the control group (t=-1.357,P=0.180).The intraoperative blood loss (t=-2.646,P=0.010),chest tube retention time (t=-2.302,P=0.025),and hospitalization days (t=-2.274,P=0.027) in the calcified lymph node group were higher than those in the control group. Conclusion Calcified lymph nodes increase the difficulty and risk of VATS lobectomy in the COPD patients with lung cancer.The findings of this study are conducive to predicting the perioperative process of VATS lobectomy.

Human papillomavirus independent status on pathologic response and outcomes in locally advanced cervical cancer managed with chemoradiotherapy followed by surgery

ObjectiveWhile human papillomavirus (HPV) has been shown to play a significant role in cervical cancer carcinogenesis (HPV associated cases), a considerable percentage of cervical cancers occur independently of HPV status...

Energy‐efficient covert communication with adaptive assist nodes group

AbstractIn this paper, a joint detection strategy of Willie based on two phases observation is proposed and an energy‐efficient covert communication scheme with an adaptive assist nodes group (AANG) based on uniform jamming power (UJP) strategy is proposed to against the joint‐phase detection of Willie, which achieves covert communication with lower energy cost and higher average covert rate (ACR). The probability of detection error (PDE) at Willie with joint‐phase detection and ACR are derived. Furthermore, the optimal power allocation of legitimate transmitters is resolved to maximize ACR. Numerical results demonstrate the benefit of the proposed scheme over the covert rate and consumed jamming power.

ST-PBFT: An Optimized PBFT Consensus Algorithm for Intellectual Property Transaction Scenarios

For the current Intellectual Property (IP) transaction scenario, consensus nodes need to simultaneously consensus transactions of the same transaction type, resulting in low consensus efficiency, accuracy, and reliability, which seriously hinders the development of intellectual property. Based on the consortium chain, this paper proposes a secure and efficient blockchain-distributed consensus algorithm, ST-PBFT (Shard Transaction Practical Byzantine Fault Tolerance), applied to the IP transaction scenario. The main contributions of ST-PBFT include the following: first, a grouping method based on the principle of consistent hashing is proposed to group consensus nodes, and nodes group consensus, which reduces the complexity of communication. Second, the transaction consensus group can process IP transactions in parallel, which improves the throughput of the algorithm. Third, a node reputation evaluation model is proposed, which can prevent byzantine nodes from being repeatedly elected as primary nodes. The experimental results show that ST-PBFT can significantly improve the consensus efficiency and reliability and reduce consensus latency.

The Effect of the Consortium Agreements on the Competence of the International Centre for Settlement of Investment Disputes (ICSID): Analytical Study of the Saudi Foreign Investment System and the Washington Agreement of 1965

This study determines the extent of the impact of the consortium agreements between commercial companies on the jurisdiction of the International Centre for Settlement of Investment Disputes (ICSID). For the settlement of foreign investment disputes, if the issue arises from the same dispute between foreign investors from several countries, who are linked to each other by a nodal group on the one hand, and with the Kingdom of Saudi Arabia as the host country for investment on the other hand. This study has shown that in some cases, consortium agreements have an indirect role in the emergence of several simultaneous judicial or arbitration procedures for the procedures of the center for settling foreign investment disputes in the Kingdom of Saudi Arabia, considering that the Kingdom of Saudi Arabia is a member of the Washington Agreement of 1965. In this study, we rely on the comparative analytical approach by studying the special nature of the consortium agreements that arise from the alliance of several companies or projects from different countries. These parties bring together an independent legal entity with an independent legal personality to explain that the consortium is considered one of the indirect reasons for the emergence of Simultaneous arbitration procedures for the ICSID. We also rely on the comparative approach between the Saudi Foreign Investment Law of 2000 and the Washington Agreement of 1965 to determine the extent of the impact of these agreements on attracting foreign investors in the Kingdom of Saudi Arabia. Additionally, we try to identify the legal means to prevent the occurrence of this phenomenon or control it if it occurs.&#x0D; &#x0D; Received: 16 November 2022 / Accepted: 27 December 2022 / Published: 5 January 2023

Double Model Following Adaptive Control for a Complex Dynamical Network

This paper formulates and solves a new problem of the double model following adaptive control (MFAC) of nodes and links in a complex dynamical network (CDN). This is different from most existing studies on CDN and MFAC. Inspired by the concept of composite systems, the CDN with dynamic links is regarded as an interconnected system composed of an interconnected node group (NG) and link group (LG). Guided by the above-mentioned new idea of viewing a CDN from the perspective of composite systems, by means of Lyapunov theory and proposed related mathematical preliminaries, a new adaptive control scheme is proposed for NG. In addition, to remove the restriction that the states of links in a CDN are unavailable due to physical constraints, technical restraints, and expensive measurement costs, we synthesize the coupling term in LG with the proposed adaptive control scheme for NG, such that the problem of double MFAC of nodes and links in CDN is solved. Finally, a simulation example is presented to verify the theoretical results.

A meta-analysis of cases of Rosai Dorfman disease reported on the African continent and a description of two cases from a tertiary academic hospital in Johannesburg, South Africa.

Rosai-Dorfman-Destombes disease (RDD) is a rare non-Langerhans cell histiocytosis characterized by the accumulation of activated histiocytes within affected tissues. The original haematopathological description of RDD has links to the late South African born haematopathologist, Ronald Dorfman, with a descriptive account of two cases of the disease treated at Chris Hani Baragwanath Academic Hospital are described herein. Alongside the two case descriptions is a meta-analysis of 149 published cases from the African continent. Sequential literature searches were performed on Google Scholar and PubMed with the search terms "sinus histiocytosis with massive lymphadenopathy", "Rosai-Dorfman disease", "Rosai-Dorfman Destombes" and "lymphadenopathy" together with the name of each individual country on the African continent, from Algeria to Zimbabwe. All possible cases of RDD reported in published literature from Africa were captured on a Microsoft Excel spreadsheet recording details, where available, of demographics, nodal (nodal groups) or extra-nodal disease as well as treatment. Of the 54 African countries on the continent, published data was available from half of these countries (n=27). Nigeria (35), Tunisia (25) and South Africa (23) contributed the majority of cases for data collection with a clear paucity of reportable information available from Central Africa. Of the 149 cases from the African continent, the majority were from patients aged ten years and younger with a decrease in reported cases in patients with increasing age. The mean age at diagnosis was 25.66 years [95% CI: 21.81-29.51] with a median age of diagnosis of 24.5 years. The youngest patient in the series was 3 months old and the oldest patient aged 72 (range 71.75 years, IQR 31). The cases reported were fairly split between males and females with a male-to-female ratio of 1.07: 1. HIV seropositivity was reported in seven patients (4.8%) and no HIV results were available in 104 patients (71.2%). Disease presentation was split between nodal disease in 43% of patients (n=64), Extra nodal (EN) disease in 32.9% (n=32), mixed (nodal/EN) disease in 11.4% (n=17) and unknown in 12.8% (n=19). Fever was present in 18.1% (n=27) of cases. Hepatic enlargement was noted in nine patients (6%) and splenic enlargement in four patients (2.7%). Commonly ascribed sites of EN disease, in descending order, were skin and soft tissue, ocular, ear/nose/throat (ENT), abdominal organ(s), bone, lung/pleura, brain parenchyma (including dura), endocrine glands, spine, breast, pericardium, pseudotumour formation (unspecified site), joint(s), peripheral nerves and genitourinary tract disease. The upfront administration of glucocorticosteroids was seen in the majority of cases. Rosai-Dorfman-Destombes, although a rare disorder, should be considered as a differential diagnosis in patients with massive bilateral cervical lymphadenopathy and is confirmed with accompanying pathological changes on microscopic and immunohistochemical examination of biopsy specimens. The role of infection, particularly HIV infection, is considered to be a possible contributor to the pathogenesis of RDD and HIV testing in patients from areas of high HIV endemicity with co-existing RDD should be undertaken. Consideration for mycobacterium tuberculosis infection in patients with generalized significant lymphadenopathy still remains an important differential for massive lymphadenopathy and requires confirmation by appropriate microbiological investigations. The treatment landscape in RDD is limited in many resource-poor settings, with the upfront use of glucocorticosteroids employed routinely in the majority of cases.

The importance of sentinel lymph node diagnostic biopsy from the lateral neck compartment in the surgical treatment of papillary thyroid cance.

The aim of our study is to determine whether mapping the lymphatic drainage and diagnostic excision of lymph nodes from lateral neck compartment is able to detect ultrasound unknown metastases in this compartment early and thus favorably affect the prognosis of patients with papillary thyroid cancer (PTC). Lymph node involvement in the lateral neck compartment is seen in 30-60 % of patients with PTC at the time of diagnosis and affects the prognosis of patients in terms of disease recurrence. From June 2012 to December 2016, 154 patients with no evidence of lateral nodal involvement on imaging studies were treated with total thyroidectomy and central comparment neck dissection. A volume of 0.2 ml of Patent Blue dye was applied in the upper half of the thyroid gland with subsequent exposure of lymphatic drainage in the lateral compartment and 2-3 sentinel lymph nodes (SLN) were removed for frozen section (Group 1). In case of metastatic involvement, a lateral comparment neck dissection was performed. The reference groups were composed of aset of patients without detected lymphatic drainage (Group 2) and a set of patients who underwent lateral compartment neck dissection for preoperatively detected metastases in the lymph nodes (Group 3). The biochemical, structural and overall persistence of the disease at the time of administration of adjuvant radioiodine ablation was evaluated. The SLN identification rate was 95.45 %. In Group 1, a total of 32 patients had a positive SLN. Out of these, 24 patients had positive SLNs based on the analysis of frozen section, while in 8 patients, the positive diagnosis was confirmed through definitive histology. The comparison of data from the entire follow-up period in all three groups of patients revealed statistically significant differences in persistence of disease, namely in favor of Group 1. The percentage of reoperations for persistence and recurrence of disease was significantly lowest in Group 1 (2.04 %) compared to Groups 2 and 3 (6.94 % and 45.45 % respectively). The method is safe and sensitive for detecting unknown lymph node metastases in the lateral neck compartment, and may facilitate adecision to perform accurate surgical treatment of patients with PTC (Tab. 4, Fig. 2, Ref. 38).

Evaluation of doses to pelvic lymph node regions from image-guided high-dose-rate interstitial brachytherapy for carcinoma of the uterine cervix.

Interstitial brachytherapy (ISBT) is indicated for intact cervical carcinoma (IN-CC) if intracavitary brachytherapy (ICRT) is not feasible and also in vault carcinoma (VA-C). We aimed to evaluate the doses to pelvic lymph node regions in IN-CC and VA-C treated with ISBT. Ten patients (6 IN-CC, 4 VA-C) were chosen for this dosimetric study. IN-CC had a central tandem in addition to the needles. External iliac (EI-N), internal iliac (II-N), obturator (OB-N) and sacral (SA-N) groups of lymph nodes were delineated. A dose of 10 grays (Gy) and 8 Gy each × 2 fractions was prescribed to the target in IN-CC and VA-C respectively. Doses received by 100%, 90% and 50% volume (D100, D90, D50) and D2cc, D1cc, D0.1cc were evaluated. Doses to lymph nodal groups in IN-CC vs. VA-C were compared using Student's t-test. For 20 implants, the median number of needles was 18 (range, 16-20). Mean D90 and D2cc of the combined bilateral OB-N, II-N, EI-N and SA-N groups were 33.62 ±3.46% and 102.94 ±10.71%, 6.98 ±0.65% and 39.69 ±3.64%, 5.1 ±0.51% and 15.4 ±0.8%, 7.76 ±0.95% and 15.36 ±1.09% of the prescribed doses respectively. Patients with a central tandem (IN-CC) received significantly higher doses to external, internal iliac and sacral group of lymph nodes (p < 0.001) as compared to VA-C. In patients with cervical carcinoma treated with ISBT, pelvic lymph node groups received significant doses. The dose contribution to pelvic lymph nodes is higher in patients with intact cervical cancer where a central tandem is used as compared to post-operative patients.

AN EVALUATION OF COMPUTING IN COMPUTER CLUSTER

A computer cluster is a collection of connected computers that work together to create a single computer. Cluster components are typically connected through LAN. Most often, clusters are used to increase performance and/or availability over what is offered by a single computer. It is more economical than alternatives. The cluster computer’s primary goal is to utilize processing node groupings to finish the task more quickly. By moving loads from busy to idle nodes, it is accomplished. Transferring additional loads from active nodes to idle nodes is the method used to accomplish this goal.

Prediction of Link Failure in MANET-IoT Using Fuzzy Linear Regression

A Mobile Ad-hoc NETwork (MANET) contains numerous mobile nodes, and it forms a structure-less network associated with wireless links. But, the node movement is the key feature of MANETs; hence, the quick action of the nodes guides a link failure. This link failure creates more data packet drops that can cause a long time delay. As a result, measuring accurate link failure time is the key factor in the MANET. This paper presents a Fuzzy Linear Regression Method to measure Link Failure (FLRLF) and provide an optimal route in the MANET-Internet of Things (IoT). This work aims to predict link failure and improve routing efficiency in MANET. The Fuzzy Linear Regression Method (FLRM) measures the long lifespan link based on the link failure. The mobile node group is built by the Received Signal Strength (RSS). The Hill Climbing (HC) method selects the Group Leader (GL) based on node mobility, node degree and node energy. Additionally, it uses a Data Gathering node forward the information from GL to the sink node through multiple GL. The GL is identified by linking lifespan and energy using the Particle Swarm Optimization (PSO) algorithm. The simulation results demonstrate that the FLRLF approach increases the GL lifespan and minimizes the link failure time in the MANET.

An approach to generate damage strategies for inter-domain routing systems based on multi-objective optimization.

Inter-domain routing systems are important complex networks on the Internet. It has been paralyzed several times in recent years. The researchers pay close attention to the damage strategy of inter-domain routing systems and think it is related to the attacker's behavior. The key to the damage strategy is knowing how to select the optimal attack node group. In the process of selecting nodes, the existing research seldom considers the attack cost, and there are some problems, such as an unreasonable definition of attack cost and an unclear optimization effect. To solve the above problems, we designed an algorithm to generate damage strategies for inter-domain routing systems based on multi-objective optimization (PMT). We transformed the damage strategy problem into a double-objective optimization problem and defined the attack cost related to the degree of nonlinearity. In PMT, we proposed an initialization strategy based on a network partition and a node replacement strategy based on partition search. Compared with the existing five algorithms, the experimental results proved the effectiveness and accuracy of PMT.

Finding the most degree-central walks and paths in a graph: Exact and heuristic approaches

In network analysis, node centrality is used to quantify the importance of a node to the structure of the network. One of the most natural and widely used centrality measures is degree centrality, defined as the number of nodes adjacent to a given node. A simple generalization of this concept that arises in many real-life applications is to consider the centrality of node groups, including subgraphs with specific connectivity properties. In this paper, we consider the problem of finding the most central walk in a network, where the centrality of the walk is given by the size of its immediate neighborhood. We begin with the problem of finding the most central shortest path and show that this problem can be solved in polynomial time. We then focus on finding other types of most central walks, such as general walks, trails, paths, and induced paths of some pre-defined length. We demonstrate that in contrast to the most central shortest path problem, these problems are NP-hard. We propose two types of linear MIP formulations to solve these problems exactly that rely on two interpretations of a walk: a sequence of visited nodes and a sequence of traversed edges. In addition, we develop two heuristic algorithms and demonstrate their effectiveness by comparing them with the exact solutions obtained using MIPs; we also exploit heuristic solutions to warm-start the MIP solver. Finally, we test our solution approaches using synthetic and real-life networks in an extensive computational study, which allows us to provide some interesting insights and observations.

Meningkatkan Kinerja Protokol Routing Aomdv Dalam Memilih Node Tetangga Berdasarkan Bandwidth, Round Trip Time, Dan Packet Loss Ratio Untuk Menemukan Rute Terbaik

Mobile ad hoc network or in short MANET is a group of node that exchange the information from source node to destination node on wireless network. The main problem in MANET is on the network structure that change continously that is cause by node mobility that made route disconnected. If route disconnect there will be another route discovery processes that will take much time. AOMDV (Ad hoc On-demand Multipath Distance Vector) routing protocol works by doing broadcast Route Request Packet (RREQ) from source node to neighbor node (intermediate node) and then it will continously until it arrives to destination node. AOMDV didnt choose the best neighbor node while broadcast RREQ packet so the route constructed have high possibility to disconnected and must re-broadcast until it find stable route and it will be a long time and not effective. To solve this problem it proposed to add a modification with AOMDV routing protocol with calculation of bandwidth, round trip time, and packet loss ratio to choose neighbor node to find the best route. Routing protocol performance will tested using test parameter throughput, delay, and packet delivery ratio to choose the best neighbor node. Based on test result, the proposed modification can improve the preformance of AOMDV routing protocol. After modification, average throughput has improved 43.26 %, Packet Delivery Ratio (PDR) improved 3.15 % and average end-to-end delay reduce 31.26%.

Normal size of benign upper neck nodes on MRI: parotid, submandibular, occipital, facial, retroauricular and level IIb nodal groups

Nodal size is an important imaging criterion for differentiating benign from malignant nodes in the head and neck cancer staging. This study evaluated the size of normal nodes in less well-documented nodal groups in the upper head and neck on magnetic resonance imaging (MRI). Analysis was performed on 289 upper head and neck MRIs of patients without head and neck cancer. The short axial diameters (SAD) of the largest node in the parotid, submandibular, occipital, facial, retroauricular and Level IIb of the upper internal jugular nodal groups were documented and compared to the commonly used threshold of ≥ 10mm for diagnosis of a malignant node. Normal nodes in the parotid, occipital, retroauricular and Level IIb groups were small with a mean SAD ranging from 3.8 to 4.4mm, nodes in the submandibular group were larger with a mean SAD of 5.5mm and facial nodes were not identified. A size ≥ 10mm was found in 0.8% of submandibular nodes. Less than 10% of the other nodal group had a SAD of ≥ 6mm and none of them had a SAD ≥ 8mm. To identify malignant neck nodes in these groups there is scope to reduce the size threshold of ≥ 10mm to improve sensitivity without substantial loss of specificity.