Recurrence Research Articles

Consensus of Chinese experts on the diagnosis and treatment of anal fistula (2020)

Anal fistula is one of the most common diseases in colorectal and anal surgery. Most of them are formed after the abscess of perianal space reptures. Due to the complexity and diversity of pathological changes, the clinical efficacy of some patients is not optimistic, and there may even be serious surgical complications, including delayed healing of anal fistula or varying degrees of fecal incontinence, which significantly affect the quality of life of patients and even lead to disability. The Working Committee of Clinical Guidelines of Anorectal Physicians Branch of Chinese Medical Association organized some domestic experts to discuss and prepare this expert consensus. It is suggested that comprehensive evaluation of anal fistula, including detailed medical history, physical examination and necessary auxiliary examination should be conducted before treatment. Auxiliary examinations include fistulography, ultrasound, CT or MRI. The purpose of the auxiliary examination is to accurately determine the position of the internal orifice of the anal fistula, the direction of the fistula and its relationship with the anal sphincter. Adenogenic anal fistula needs surgical treatment after diagnosis. The operation methods can be divided into two types: operations breaching sphincter and operations preserving sphincter function. The former includes anal fistulectomy, anal fistulotomy and seton placement; the latter includes ligation of intersphincteric fistula (LIFT), rectal mucosal muscle flap advancement repair, anal fistula laser closure, video-assisted anal fistula treatment, etc. It is suggested to select or combine the application according to the specific condition of patients. Bioabsorbable materials include anal fistula plug and fibrin glue. Due to the characteristics of retaining sphincter function and reusability, it is recommended to be used selectively by qualified and experienced doctors. Proper wound management after anal fistula surgery can reduce the pain of patients, promote healing and reduce the recurrence of anal fistula. Because there is a certain risk of recurrence and fecal incontinence after anal fistula surgery, for some patients with complex condition, repeated operations or impaired anal function, we must be careful when choosing reoperation, and weigh the benefits of patients and the risk of fecal incontinence.

Drugs Susceptibility Testing in Leprosy Patients from Côte d’Ivoire Reveals Multidrugs Resistance Combination Cases to Dapsone, Rifampicin and Ofloxacin

Leprosy is a chronic tropical infectious skin disease caused by an obligate intracellular pathogen called Mycobacterium leprae. Until now no vaccine was available so early diagnosis and treatment were the basic strategy for leprosy control. The treatment is based on combined drug therapy including Dapsone, Rifampicin, and Ofloxacin according protocols recommended by the WHO. However, anti-leprosy drugs resistance has been reported in several leprosy endemic region. The drug susceptibility testing was done by detecting mutation after sequencing of the drug resistance determining region. Cote d'Ivoire like many African countries has reaching the threshold of elimination of the disease and the PCT is available nationwide. On the basis of recurrences of therapeutic failures that could be due to misobservance of patients drug therapy or eventually due to circulating resistant strains, we evaluated the drug susceptibility in 155 patients from a leprosy care center in Cote d’Ivoire. Patients were previously diagnosed by clinicians and confirmed by PCR then the genetic drug susceptibility was done by PCR-direct sequencing of the drug resistance determining region of rifampicin, dapsone and ofloxacin used in the treatment. Our results showed multiple cases of multiresistance to anti-leprosy drugs in Cote d’Ivoire. This should be an alert for antibiotic resistance observatories, and policies so that more active surveillance was carried out for the control and surveillance of M. leprae resistance to drugs.

Analysis of diagnosis and treatment of 100 patients with Hürthle cell adenoma

Objective To summarize and analyze the clinical data and prognosis of the patients with Hurthle cell tumor (HCT) in order to raise the clinicians' awareness of the disease. Methods The clinical data on patients with histopathologically proven HCT, without other thyroid carcinomas, were collected retrospectively in Peking University First Hospital from January 2001 to February 2017. All the patients underwent surgery due to thyroid nodules. The follow-up information was also collected. Results A total of 100 patients were enrolled in the current study. All of them were diagnosed with Hurthle cell adenoma (HCA). There were 77 females and 23 males, with the male-to-female ratio of 1 : 3.3. The average age of these patients was (52±14) years at the time of operation. Fifty-one patients were found their thyroid nodules accidentally by ultrasonography during their health check-ups. 69.4% of the 49 symptomatic patients presented with painless cervical nodules. 83.0% HCA patients were combined with multinodular goiters (MNGs). 88.4% (76/86) patients were euthyroid and 53.8% (21/39) had increasing thyroglobulin levels. The mean longest diameter of HCAs was (3.2±1.5) cm (range: 0.9-7.3 cm) on ultrasonography. There were a series of sonographic features of HCA, such as larger, solidity, hypoecho, a smooth outline, intranodular vascularization, perinodular vascularization, absence of calcification in nodules and absence of enlarged cervical lymph nodes. Compared with the histological diagnosis, the diagnostic accuracy by frozen section (FS) during operation was 97.4%. Twenty-nine patients were followed up with an average period of (49.2±22.1) months and none of them had local recurrence or cervical lymph node metastasis. Six patients accepted thyroid hormone replacement treatment and one had thyrotoxicosis due to over-dose. Conclusion HCA is more common in women. It is often found accidentally by ultrasonography during their health check-ups or presented with painless cervical nodules. It is combined with MNG frequently. HCA exhibits numerous sonographic features but not unique. FS during operation is a reliable method to identify HCA with high diagnostic accuracy. Patients with thyroid hormone administration should be monitored for thyroid function after thyroid surgery.

Spondylectomy in the Treatment of Neoplastic Spinal Lesions – A Retrospective Outcome Analysis of 582 Patients Using a Patient-Level Meta-Analysis

Background: En-bloc spondylectomy in the treatment of spinal tumors is a complex procedure with potential complications. This study aims at identifying predictors of postoperative complications, lesion recurrence and overall survival. Methods: A systematic review of the literature was conducted, and patient-level data extracted from the included studies. Multiple linear-regression models were calculated to predict the occurrence of postoperative complications, lesion recurrence and overall survival based on age, tumor etiology, surgical approach, mode of resection (en-bloc versus intralesional), tumor extension based on Weinstein-BorianiBiagini classification system and number of levels treated. Results: Data of 582 individual adult and pediatric patients were extracted from the literature; Patient characteristics are: 45% female, median age of 46 years (range 5-78); most common etiologies were: sarcoma (46%), metastases (31%) and chordoma (11%). The surgical technique was: anterior (2.5%), combined (45%) and posterior approach (52.4%); 68.5% underwent en-bloc spondylectomy; average levels resected were 1.6 (1-6); 65% of patients had neurologic deficits at presentation, average survival was 2.6 years; Direct procedure-related complications were observed in 17.7%, with the most prevalent being CSF leaks, wound infections and neural injury. For postoperative complications, recurrence and 5-year survival significant regression equations were found (F(7,90)=2.57, p=0.018) with an R2 of 0.1; (F(5,147)=2.35, p=0.044) with an R2 of 0.07 and (F(4,101)=7.2, p=0.01) with an R2 of 0.38. Odds ratio for predicted complications was 1.35 for en-bloc resection and 1.25 for more than one level treated. The odds ratio for tumor recurrence was 0.78 for en-bloc resection; odds ratio for 5-year survival were 0.79 for increased patient age, 0.65 for increasing tumor grade, 0.79 for tumor dissemination at diagnosis and 1.68 for en-bloc resection. Conclusion: En-bloc spondylectomy provides improved survival and lower recurrence rates but also higher operative complication rates when compared to intralesional resections. Interestingly the complication rate was not influenced by tumor stage (WBB scale) and tumor etiology.

Comment on: “Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence”

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Presunta parálisis periódica hipercalémica con miotonía en perros Shi-Tzú y Pastor Alemán

En los humanos, las canalopatías del músculo esquelético son entidades de base genética y de incidencia muy baja. En relación al canal de sodio en particular, las diferentes mutaciones SCN4A pueden dar lugar a diversos fenotipos que van desde la parálisis muscular (parálisis periódica hipercalémica, parálisis periódica hipocalémica) a la hiperexcitabilidad muscular (paramiotonía congénita, miotonías agravadas por potasio), pasando por fenotipos combinados de las dos anteriores. Existe una estrecha interrelación entre la parálisis periódica hipercalémica y las miotonías; ambas características pueden coexistir en el mismo paciente.Este trabajo describe un cuadro clínico que afectó a una camada de 7 cachorros Pastor Alemán y a una camada de 4 cachorros Shi-Tzú, con episodios caracterizados por un fenotipo clínico de parálisis muscular combinado con hiperexcitabilidad muscular.De acuerdo a los hallazgos clínicos (fenomenología clínica, edad de aparición, recurrencia de los episodios, ausencia de signos clínicos entre los episodios) y de laboratorio (hipercalemia), y a los resultados del tratamiento con acetazolamida, el diagnóstico presuntivo fue parálisis periódica hipercalémica con miotonía/paramiotonía por una canalopatía SCN4A.Destacamos la importancia del diagnóstico clínico para estas raras patologías. En ausencia de diagnóstico genético, los métodos de diagnóstico complementario tiene valor limitado debido al carácter funcional de estos trastornos.Proponemos esta comunicación como la primera de este tipo en perros de raza Pastor Alemán y Shi-Tzú. In humans, skeletal muscle channelopathies are genetic disease with very low incidence. Regarding the sodium channel in particular, the different SCN4A mutations can result in various phenotypes ranging from muscle paralysis (hyperkalemic periodic paralysis, hypokalemic periodic paralysis) to muscle hyperexcitability (congenit paramyotonia, myotonias aggravated by potassium), through combined phenotypes of the previous two. There is a close interrelation between hyperkalemic periodic paralysis and myotonias; both characteristics can coexist in the same patient.This work describes a clinical picture affecting a litter of 7 German Shepherd puppies and a litter of 4 Shih-Tzu puppies with episodes characterized by a clinical phenotype of muscular paralysis combined with muscular hyperexcitability.Based on clinical findings (clinical phenomenology, age of onset, episodic recurrence, absense of clinical signs in the period between episodes) and laboratory (hyperkalemia), and the results of treatment with acetazolamide, the presumptive diagnosis was hyperkalemic periodic paralysis with myotonia/paramyotonia due to SCN4A channelopathy.We emphasize the importance of clinical diagnosis for these rare pathologies. In absence of genetic diagnosis, complementary diagnostic methods have limited value due to the functional nature of these disorders.We proposed this description as the first communication of this type in German Shepherd and Shi-Tzu dogs.

Qualitative Findings Following Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence

Background: Fear of cancer recurrence (FCR) takes an emotional toll on cancer survivors and significantly undermines quality of life following treatment. During a randomized controlled trial of Acceptance and Commitment Therapy (ACT) for post-treatment breast cancer survivors with clinically significant FCR, we conducted qualitative interviews to glean a deeper understanding of the impact of ACT on survivors’ coping with FCR. 
 Methods: Breast cancer survivors (stage I-III) who had completed a 6-week ACT intervention were invited to share their experiences in semi-structured qualitative interviews. Interviews were transcribed verbatim and analyzed thematically using a deductive approach. Participants received a $25 gift card for their time. Participants (n=16) were primarily White (81.3%) and college educated (68.8%), with a mean age of 57.3 (SD=11.1) and 75% had an income over $50,000. 
 Results: Prior to the study, survivors generally coped with FCR by denying their FCR or by attempting to control their fears through faith, lifestyle management, avoidance, and positivity. Survivors uniformly noted the sense of community they felt in their ACT group when listening to other survivors describe their own struggle with FCR. This common bond created a foundation that allowed survivors to embrace the ACT intervention and develop adaptive coping skills related to acceptance, present-moment awareness, and living consistently with one’s values. Survivors noted that these skills reduced the negative impact of FCR and other life challenges and improved quality of life compared to pre-study coping techniques. 
 Conclusion and Potential Impact: By building trust with other cancer survivors, participants were able to shift from attempts to ‘control’ FCR to a more ‘accepting’ approach to manage FCR and other life stressors. While research with a larger group of participants is needed, initial findings indicate that ACT may be a promising addition to care for cancer survivors.

Analytical assessment of the frequency of natural vibrations of a truss with an arbitrary number of panels

The aim of the work is to derive a formula for the dependence of the first frequency of the natural oscillations of a planar statically determinate beam truss with parallel belts on the number of panels, sizes and masses concentrated in the nodes of the lower truss belt. Truss has a triangular lattice with vertical racks. The solution uses Maple computer math system operators. Methods. The basis for the upper estimate of the desired oscillation frequency of a regular truss is the energy method. As a form of deflection of the truss taken deflection from the action of a uniformly distributed load. Only vertical mass movements are assumed. The amplitude values of the deflection of the truss is calculated by the Maxwell - Mohrs formula. The forces in the rods are determined in symbolic form by the method of cutting nodes. The dependence of the solution on the number of panels is obtained by an inductive generalization of a series of solutions for trusses with a successively increasing number of panels. For sequences of coefficients of the desired formula, fourth-order homogeneous linear recurrence equations are compiled and solved. Results. The solution is compared with the numerical one, obtained from the analysis of the entire spectrum of natural frequencies of oscillations of the mass system located at the nodes of the truss. The frequency equation is compiled and solved using Eigenvalue search operators in the Maple system. It is shown that the obtained analytical estimate differs from the numerical solution by a fraction of a percent. Moreover, with an increase in the number of panels, the error of the energy method decreases monotonically. A simpler lower bound for the oscillation frequency according to the Dunkerley method is presented. The accuracy of the lower estimate is much lower than the upper estimate, depending on the size and number of panels.

Venous outflow congestion is related to poor recurrence-free survival of living donor liver transplantation recipients with hepatocellular carcinoma - a retrospective study.

This study analyzed the impact of venous outflow congestion in the liver graft on hepatocellular carcinoma recurrence in liver transplantation recipients. Hepatocellular carcinoma patients who underwent living donor liver transplantation at Samsung Medical Center between 2007 and 2018 were included. The congested volume was calculated based on 2-week post-transplantation computed tomography. Recurrence-free survival and overall survival were analyzed using the multivariable Cox proportional hazard model including the degree of venous congestion. A total of 582 patients were included. There were 232 patients (39.9%) with certain degree of congestion volume. Kaplan-Meier survival analyses showed 1-, 5-, and 10-year recurrence-free survivals of 86.0%, 72.2%, and 70.7%, respectively, and overall survivals of 91.5%, 73.4%, and 68.9%, respectively. While congestion volume per 10cm3 was a significant risk factor for recurrence-free survival (HR=1.024, CI: 1.002-1.047, P=0.034), there was no significant relationship with overall survival. (HR=1.015, CI: 0.992-1.039, P=0.213). Venous outflow congestion in the liver after living donor liver transplantation was related to the poor recurrence-free survival of hepatocellular carcinoma patients.

Recurrence of Skin and Soft Tissue Infections

Skin and soft tissue infections (SSTIs) are a common manifestation of Staphylococcus aureus (SA) and have widely variable recurrence rates. To

Minimally invasive surgery in cervical cancer.

In recent years, minimally invasive surgery has replaced open surgery for almost all surgical indications in gynecological practice. Recently, the results of the Laparoscopic Approach to Cervical Cancer (LACC) trial questioned the role of minimally invasive surgery for patients affected by earlystage cervical cancer. In the present paper, we discussed the current evidence regarding the adoption of minimally invasive surgery for patients with cervical cancer. We evaluated the current evidence focusing on four interesting features: (i) the impact of tumor volume; (ii) reasons explaining worse outcomes of patients undergoing minimally invasive surgery; (iii) methods to reduce the risk of recurrence during minimally invasive surgery; and (iv) the effect of minimally invasive surgery in patients with locally advanced cervical cancer. At the moment, in the light of current evidence, minimally invasive radical hysterectomy should be offered only in the context of clinical trials. Extensive counseling and appropriate patients' selection are needed. Further prospective evidence is warranted to identify the better approach for cervical cancer patients.

Hepatocellular CarcinomaPost Viral Hepatitis B and C:Application of the PrognosticScore of Singapore

Surgical resection of hepatocellular carcinoma (HCC) is a major curative option in patients with adequate residual liver function. The risk of recurrence is extremely high. The Singapore liver cancer recurrence (SLICER) is a nomogram that evaluates the 3-year and 5-year recurrence-free survival (RFS) of patients operated for HCC. The objectives of our study were: To apply the SLICER prognostic score to a series of patients operated for a CHC To compare the results found with specific evolutionary data in our patients

Safe Combination of Cisplatinand Metformin Reverts theMalignant Ascites in a MouseModel to a Solid Tumor byDownregulation of ÎNp63 andInduces Tumor Dormancy via mTOR/ p21 Mechanism

Currently, combination therapy has become the cornerstone of cancer treatment. The combination of different anti-cancer mechanisms can induce tumor cell quiescence. However, toxicity to normal tissue is the major limitation of existing combined drugs. In this study, Ehrlich ascites carcinoma (EAC) inoculated into mice was targeted with just one dose of cisplatin and later doses of metformin, a safe anti-diabetic drug with an anti-cancer effect, to maintain EAC cells in the quiescent state and secure a longer survival time without tumor recurrence. The group that underwent dual therapy had developed a delayed solid tumor instead of a malignant ascites. Induction of chemo-quiescence in the EAC cells was proven by downregulation of mechanistic target of rapamycin (mTOR) and upregulation of cyclin- dependent kinase inhibitor 1 (p21) expressions. Intriguingly, the conversion of free neoplastic cells into a solid tumor was associated with a significant decrease in ΔNp63 immunostaining in EAC cells. Taken together, a single dose of cisplatin followed by metformin doses could overcome the aggressiveness of malignant ascites by the conversion into a solid tumor, induction of chemo-quiescence and extension of survival time

Percutaneous tumor ablation versus partial nephrectomy for small renal mass: the impact of histologic variant and tumor size.

BACKGROUND To investigate recurrence rates in patients with T1 renal cell carcinoma (RCC) undergone partial nephrectomy (PN), radiofrequency ablation (RFA) or cryoablation (Cryo). METHODS We retrospectively evaluated data from 665 (81.4%), 68 (8.3%) and 83 (10.3%) patients who underwent PN, RFA and Cryo, respectively. Kaplan-Meier curves depict recurrence-free survival (RFS) rates in the overall population and after stratifying according to tumor's histology (namely, clear cell RCC and non-clear RCC) and size (namely < 2 cm and 2-4 cm). Multivariable Cox regression model was used to identify predictors of recurrence. Cumulative-incidence plots evaluated disease recurrence and other causes of mortality (OCM). RESULTS Patients referred to PN experienced higher RFS rate compared to those treated with RFA and Cryo at 60-month in the overall population (96.4% vs. 79.4 % vs. 87.8%), in patients with clear cell RCC (93.3% vs 75% vs. 80.4%) and in those with tumor of 2-4 cm (97.3% vs 78% and 84.4%; all p≤0.01). In patients with non-clear cell RCC and with tumor <2cm, PN showed higher RFS rate at 60-month as compared to RFA (97.9% vs 84.4% and 95.1% vs 78.1%, respectively; all p≤0.02). At multi-variate analysis, ablative techniques (RFA [HR=4.03] and Cryo [HR=3.86]) were independent predictors of recurrence (all p<0.03). At competing risks analysis, recurrence rate and OCM were 7.3% and 1.3% vs 25% and 7.2% vs 19.9% and 19.9% for PN, RFA and Cryo, respectively. CONCLUSIONS PN and Cryo showed similar RFS rates in patients with non-clear cell RCC and with renal mass < 2cm.

Homogeneous mappings of regularly varying vectors

It is well known that the product of two independent regularly varying random variables with the same tail index is again regularly varying with this index. In this paper, we provide sharp sufficient conditions for the regular variation property of product-type functions of regularly varying random vectors, generalizing and extending the univariate theory in various directions. The main result is then applied to characterize the regular variation property of products of i.i.d. regularly varying quadratic random matrices and of solutions to affine stochastic recurrence equations under nonstandard conditions.

Association between pretransplant serum soluble programmed death protein 1 level and prognosis following liver transplantation in patients with hepatocellular carcinoma

Background: The study aimed to assess the prognostic influence of pretransplant serum soluble programmed death protein 1 (sPD-1) in patients undergoing liver transplantation (LT) for treatment of hepatocellular carcinoma (HCC). Methods: Data from 229 patients with HCC who underwent living donor LT between January 2010 and December 2015 were ret rospectively evaluated. Stored serum samples were used to evaluate sPD-1 concentrations. Results: Tumor recurrence, overall survival, and HCC-specific survival rates were 25.5%, 94.3%, and 96.0% at 1 year; 40.8%, 78.2%, and 80.7% at 3 years; and 44.5%, 75.4%, and 77.9% at 5 years, respectively. Prognostic analysis using pretransplant serum sPD-1 with a cutoff of 93.6 µg/mL (median value of the study cohort) did not have significant prognostic influence on HCC recur rence, HCC-specific patient survival and post-recurrence patient survival (P≥0.26). Prognostic analysis using sPD-1 with a cutoff of 300 µg/mL showed marginally higher tumor recurrence (P=0.069), similar HCC-specific patient survival (P=0.25) and higher post-recurrence patient survival (P=0.045). Multivariate analysis revealed that Milan criteria were prognostic for HCC recurrence and HCC-specific patient survival, but pretransplant sPD1 with a cutoff of 300 μg/mL did not become an independent prognostic factor. Conclusions: The results of this study demonstrate that pretransplant serum sPD-1 may not have significant influences on post transplant outcomes in patients with HCC, although there might be some potential prognostic influence from very high expres sion of serum sPD-1. Additional large-scale, multicenter studies and detailed mechanism studies are required to clarify the role of serum sPD-1 in LT recipients.

Conditional regional recurrence risk: The effect of event-free years in different subtypes of breast cancer

BackgroundRegional recurrence (RR), also known as lymph node recurrence, is an endpoint in several trials concerning reducing axillary treatment in cT1-2N0 breast cancer patients. The risk of RR may decrease with each subsequent event-free year, affecting the yield and consequently usefulness of long (er) follow-up. The aim of this study is to determine the risk of RR as a first event within five years after diagnosis in subtypes of breast cancer, conditional to being event-free for one, two, three and four years. MethodsFrom the Netherlands Cancer Registry, cT1-2N0 breast cancer patients diagnosed from 2005 to 2008 were analyzed. Subgroup analysis was performed for pT1-2N+(sn) patients. RR risk was calculated with Kaplan-Meier analysis. Conditional RR (assuming x event-free years) was determined by selecting patients without an event at x years, and calculating the remaining risk for RR within five years after diagnosis. ResultsA total of 18,009 cT1-2N0 (all pN stages) breast cancer patients were included. RR occurred in 1.3% of cT1-2N0 and 1.5% of pT1-2N+(sn) patients. The risk of RR varied between subtypes; it was highest for triple negative tumors and lowest for ER + PR + Her2-and ER + Her2+ tumors. After event-free years, the risk of RR decreased subsequently in both groups and in all subtypes. After two event-free years, the risk of RR was 0.8%. ConclusionThe absolute yield of follow-up to detect RR beyond two years is low; for every 125 event-free patients, one RR can be expected until five years. This suggests that follow-up longer than two years is of limited value for detecting RR in both clinical and research setting.

Anomalous diffusion of molecules with rotating polar groups: The joint role played by inertia and dipole coupling in microwave and far-infrared absorption.

Budó's generalization [A. Budó, J. Chem. Phys. 17, 686 (1949)10.1063/1.1747370] of the Debye rotational diffusion model of dielectric relaxation of polar molecules to an assembly with internal interacting polar groups is extended to inertial anomalous diffusion. Thus, the theory can be applied both in the GHz and the THz regions, accounting for anomalous behavior as well as the necessary return to optical transparency at very high frequencies. The linking of both dispersion regions in a single model including anomalous effects is accomplished via a fractional Fokker-Planck equation in phase space based on the continuous time random walk ansatz. The latter is written via the Langevin equations for the stochastic dynamics of pairs of interacting heavy polar groups embedded in the frame of reference of a particular molecule or molecular dimer rotating about a space-fixed axis. The fractional Fokker-Planck equation is then converted to a three-term matrix differential recurrence equation for the statistical moments. This is solved in the frequency domain for the linear dielectric response using matrix continued fractions. Thus, one has the complex susceptibility χ(ω) for extensive ranges of damping, group dipole moment ratio, and friction. The susceptibility, as inferred from the small oscillation limit, inherently comprises a low frequency (GHz) band with width depending on the anomalous parameter and a far-infrared (THz) or Poley peak of resonant character with a comblike structure of harmonic peaks. This behavior is due to the double transcendental nature of the after-effect function.

Organizational and Legal Issues of Prosecutor’s Supervision of Noncustodial Penalties’ Enforcement

The article deals with a set of issues related to the due course of law in the execution of punishments not related to isolation from society, and which have recently become widespread in the framework of the implementation of one of the directions of the state's policy in the field of combating crime - the expansion of types of punishments alternative to imprisonment. The author analyzes the powers of the prosecutor's office as a guarantor of compliance with the rule of law in the field of prosecutorial supervision, the purpose of which is, on the one hand, to identify, suppress and prevent violations of the law in the execution of criminal sentences and prevention of recurrence of crimes, and on the other, to respect the rights and legitimate interests of convicts.

Uncertain random linear quadratic control with multiplicative and additive noises

AbstractThis paper studies two types of linear quadratic (LQ) optimal control models for multistage uncertain random systems. The first model is an LQ model with additive noises, while the second model is an LQ model with both multiplicative noises and additive noises. Chance theory is a useful tool to deal with the analysis of indeterminacy including both uncertainty and randomness. Based on Bellman's principle and chance theory, the recurrence equations are presented for settling such optimal control problems. Then, by applying recurrence equations, the analytical expressions are derived for solving both the optimal objective function and optimal control strategies of the LQ models. Meanwhile, an application and a numerical example are provided to show the effectiveness of our results.