Histological regression of squamous esophageal carcinoma assessed by percentage of residual viable cells after neoadjuvant chemoradiation is an important prognostic factor

Background: Whether the TNM staging system is applicable after neoadjuvant chemoradiation in esophageal cancer is controversial. The aim of this study was to evaluate the prognostic value of histopathological regression of the primary tumor in postchemoradiated patients. Materials and Methods: The pretherapeutic and pathological ypTNM stages of patients who have had neoadjuvant chemoradiation followed by esophagectomy were analyzed. The percentage of residual viable cells of the primary tumor (ypV) and other clinicopathological factors were tested for their prognostic value. Results: Of 175 recruited patients, 55 (31.4%) achieved pathological complete response. The median survival of these 55 patients was significantly longer than those with other disease stages (124.8 vs 21.1 months) (P <.001). Gender, ypT, ypN, ypTNM, and ypV stage were significant prognostic factors in univariate analysis. In patients without nodal metastases, the median survival in patients with residual viable cells in the primary tumor (ypV?) was 24.6 months, compared with that of 124.8 months in those with no viable cells (ypV0) (P =.043). In those who had nodal metastases, the median survival of patients with ypV0 and ypV? were 21.2 months and 17.4 months respectively (P =.37). Cox regression analysis showed that male gender, high percentage of residual viable cells (ypV), and positive nodal status (ypN1) were independent predictors of poor prognosis. Conclusions: In patients who underwent neoadjuvant chemoradiation therapy, histopathological regression of the primary tumor indicated by percentage of residual viable cells is an important prognostic factor in addition to nodal status and gender. © The Author(s) 2010.published_or_final_versionSpringer Open Choice, 01 Dec 201

Gene Expression Profiling Identified High-mobility Group AT-hook (HMGA2) as Being Frequently Upregulated in Esophageal Squamous Cell Carcinoma

Background: Esophageal cancer is one of the most deadly malignancies worldwide and esophageal squamous cell carcinoma (ESCC) is the most frequent type. Methods: We identified up-regulated genes from gene expression profiles of HKESC-4 cell line, its parental tumor tissues, non-tumoral esophageal epithelia and lymph nodes with metastatic carcinoma using Human Genome U133 Plus 2.0 microarray. Results: Four genes [High-mobility group AT-hook 2 (HMGA2), paternally expressed 10 (PEG10), SH3 and multiple ankyrin repeat domains 2 (SHANK2) and WNT1 inducible signaling pathway protein 3 (WISP3)] were selected for further validation with real-time quantitative polymerase chain reaction (qPCR) in a panel of ESCC cell lines and clinical specimens. HMGA2 was found to be overexpressed in the panel of ESCC cell lines tested. By using immunohistochemistry, HMGA2 was found to be up-regulated in 70% of ESCC tissues (21 out of 30 cases). Conclusion: This study demonstrates successful use of gene microarray to identify and reveal HMGA2 as a novel and consistently overexpressed gene in ESCC cell lines and clinical samples.published_or_final_versio

Strategies for Building Environmental Transparency and Accountability

How do nature-inspired enterprises be accountable to the natural environment formed? Natural environment is one of the basic elements of the business. Firms should be sensitive to environment, so they should develop environmental transparency and accountability. This paper develops a framework to understand how environmental transparency and stakeholder governance create environmental accountability, following an “action cycle” informed by four accountability criteria—identifiability, awareness of monitoring, expectations of evaluation, and social pressure. The paper analyzes the environmental transparency practices of 50 companies listed in the annual Best Global Green Brands report, the Global RepTrak 100, and The Climate A-List of the CDP (formerly the Carbon Disclosure Project). The results show that exemplar firms improve the “what”, “how”, and “how much” factors in terms of environmental information to identify what will be disseminated to whom when the information follows the criteria of accountability, which allow stakeholders to effectively adopt a governance role. This paper provides a 2 × 2 matrix for firms and stakeholders to better understand how accountability leadership is driven by environmental transparency, stakeholder governance and accountability criteria. The practical implications of environmental transparency are highlighted, specifically in terms of strategies for building accountability to meet the growing expectations of transparency and accountability

Health-state utilities in a prisoner population : a cross-sectional survey

Background: Health-state utilities for prisoners have not been described. Methods: We used data from a 1996 cross-sectional survey of Australian prisoners (n = 734). Respondent-level SF-36 data was transformed into utility scores by both the SF-6D and Nichol's method. Socio-demographic and clinical predictors of SF-6D utility were assessed in univariate analyses and a multivariate general linear model. Results: The overall mean SF-6D utility was 0.725 (SD 0.119). When subdivided by various medical conditions, prisoner SF-6D utilities ranged from 0.620 for angina to 0.764 for those with none/mild depressive symptoms. Utilities derived by the Nichol's method were higher than SF-6D scores, often by more than 0.1. In multivariate analysis, significant independent predictors of worse utility included female gender, increasing age, increasing number of comorbidities and more severe depressive symptoms. Conclusion: The utilities presented may prove useful for future economic and decision models evaluating prison-based health programs

From planning the port/city to planning the port-city : exploring the economic interface in European port cities

In last three decades, planning agencies of most ports have institutionally evolved into a (semi-) independent port authority. The rationale behind this process is that port authorities are able to react more quickly to changing logistical and spatial preferences of maritime firms, hence increasing the competitiveness of ports. Although these dedicated port authorities have proven to be largely successful, new economic, social, and environmental challenges are quickly catching up on these port governance models, and particularly leads to (spatial) policy ‘conflicts’ between port and city. This chapter starts by assessing this conflict and argue that the conflict is partly a result of dominant—often also academic—spatial representations of the port city as two separate entities. To escape this divisive conception of contemporary port cities, this chapter presents a relational visualisation method that is able to analyse the economic interface between port and city. Based on our results, we reflect back on our proposition and argue that the core challenge today for researchers and policy makers is acknowledging the bias of port/city, being arguably a self-fulfilling prophecy. Hence, we turn the idea of (planning the) port/city conflicts into planning the port-city’s strengths and weaknesses

Employer's management of employees affected by cancer

Return to work (RTW) following treatment can be problematic for cancer survivors. Although some people affected by cancer are able to continue working, a greater proportion of these survivors end up unemployed, retire early or change jobs than those without a diagnosis of cancer. One of the reasons for not returning to work is the lack of understanding and support from employers and supervisors. Currently, it is not clear what factors are likely to influence the employer’s management of employees recovering from cancer. This article reports the outcome from a review of the published literature on factors related to the current employer management of employed cancer survivors

Genetic and polygenic risk score analysis for Alzheimer's disease in the Chinese population

Introduction: Dozens of Alzheimer's disease (AD)-associated loci have been identified in European-descent populations, but their effects have not been thoroughly investigated in the Hong Kong Chinese population. Methods: TaqMan array genotyping was performed for known AD-associated variants in a Hong Kong Chinese cohort. Regression analysis was conducted to study the associations of variants with AD-associated traits and biomarkers. Lasso regression was applied to establish a polygenic risk score (PRS) model for AD risk prediction. Results: SORL1 is associated with AD in the Hong Kong Chinese population. Meta-analysis corroborates the AD-protective effect of the SORL1 rs11218343 C allele. The PRS is developed and associated with AD risk, cognitive status, and AD-related endophenotypes. TREM2 H157Y might influence the amyloid beta 42/40 ratio and levels of immune-associated proteins in plasma. Discussion: SORL1 is associated with AD in the Hong Kong Chinese population. The PRS model can predict AD risk and cognitive status in this population

Risk and cost evaluation of port adaptation measures to climate change impacts

The long term impact posed by climate change risk remains unclear and is subject to diverse interpretations from different maritime stakeholders. The inter-dynamics between climate change and ports can also significantly diversify in different geographical regions. Consequently, risk and cost data used to support climate adaptation is of high uncertainty and in many occasions, real data is often unavailable and incomplete. This paper presents a risk and cost evaluation methodology that can be applied to the analysis of port climate change adaptation measures in situations where data uncertainty is high. Risk and cost criteria are used in a decision-making model for the selection of climate adaptation measures. Information produced using a fuzzy-Bayesian risk analysis approach is utilized to evaluate risk reduction outcomes from the use of adaptation measures in ports. An evidential reasoning approach is then employed to synthesize the risk reduction data as inputs to the decision-making model. The results can assist policymakers in developing efficient adaptation measures that take into account the reduction in the likelihood of risks, their possible consequences, their timeframe, and costs incurred.A technical study across 14 major container ports in Greater China is presented to demonstrate the interaction between cost and risk analysis, and to highlight the applicability of the stated methodology in practice. The paper offers a useful analytical tool for assessing climate change risks to ports and selecting the most cost-effective adaptation measures in uncertain conditions. It can also be used to compare the practitioners' perceptions of climate risks across different geographical regions, and to evaluate improvements after implementation of the selected adaptation measures with potential budgetary constraints. The methodology, together with the illustrative cases, provides important insights on how to develop efficient climate change adaptation measures in a supply chain context to improve the sustainability of development and enhance adaptation measures for ports, port cities, intermodal transport, supply chains, and urban and regional planning in general. © 2017 Elsevier Ltd

Port Decision Maker Perceptions on the Effectiveness of Climate Adaptation Actions

Effective adaptation to climate change impacts is rapidly becoming an important research topic. Hitherto, the perceptions and attitudes of stakeholders on climate adaptation actions are under researched, partly due to the emphasis on physical and engineering aspects during the adaptation planning process. Building on such considerations, the paper explores the perceptions of port decision makers on the effectiveness of climate adaptation actions. The findings suggest that while port decision makers are aware of potential climate change impacts and feel that more adaptation actions should be undertaken, they are skeptical about their effectiveness and value. This is complemented by a regional analysis on the results, suggesting that more tailor-made adaptation measures suited to local circumstances should be developed. The study illustrates the complexity of climate adaptation planning and of involving port decision makers under the current planning paradigm

Self-management of chronic pain in Malaysian patients: effectiveness trial with 1-year follow-up

Self-management of chronic illnesses has been widely recognised as an important goal on quality of life, health service utilisation and cost grounds. This study describes the first published account on the application of this approach to people suffering from chronic pain conditions in a Southeast Asian country, Malaysia. A heterogeneous sample of chronic pain patients in Malaysia attended a 2-week cognitive–behavioural pain management programme (PMP) aimed at improving daily functional activities and general psychological well-being. Complete datasets from 70 patients out of 102 patients who attended 11 programmes conducted from 2002 to 2007, as well as the 1-month and 1-year follow-up sessions at the hospital clinic, are reported. The pre- to post-treatment results on self-report measures indicate that significant gains were achieved on the dimensions of pain, disability and psychological well-being. These gains were maintained at both 1-month and 1-year follow-ups. The results mirror those reported from similar interventions in Europe and North America and indicate the concept of self-management of a chronic illness is acceptable and meaningful to Asian patients. Importantly, the achieved outcomes were independent of gender and ethnic group status