Previous tonsillectomy modifies odds of tonsil and base of tongue cancer

BACKGROUND: Tonsillectomy is a commonly performed surgical procedure that involves removal of the palatine tonsils. The purpose of this study is to examine the association between previous tonsillectomy and odds of oropharyngeal squamous cell carcinoma (OPSCC) in a large population-based case-control study. We hypothesise that previous tonsillectomy is associated with a decreased odds of tonsil cancer with no impact on the odds of developing base of tongue (BOT) cancer. METHODS: This was a population-based, frequency-matched case-control study with multinomial logistic regression, including 1378 controls, 108 BOT cancer cases, and 198 tonsil cancer cases. Demographic and risk factor data were collected using a structured questionnaire during an in-home visit conducted by trained nurse-interviewers. The human papillomavirus (HPV) tumour status was determined through Luminex-based multiplex PCR and p16 status by immunohistochemistry. RESULTS: Previous tonsillectomy was associated with a nearly two-fold increased odds of BOT cancer (OR=1.95, 95% CI 1.25-3.06, P=0.003) and a large decrease in the odds of tonsil cancer (OR=0.22, 95% CI 0.13-0.36, P<0.001). When HPV status was considered, tonsillectomy was associated with a decreased odds of HPV-positive tonsil cancer (OR=0.17, 95% CI 0.08-0.34, P<0.001) and an increased risk of HPV-positive BOT cancer (OR=2.46, 95% CI 1.22-4.95, P=0.012). When p16 status was considered, tonsillectomy was associated with an increased odds of p16-positive BOT cancer (OR=2.24, 95% CI 1.16-4.35, P=0.017) and a decreased odds of p16-positive tonsil cancer (OR=0.14, 95% CI 0.07-0.31, P<0.001). CONCLUSIONS: Previous tonsillectomy modifies the odds of both tonsil and BOT cancer, with decreased odds of tonsil cancer and increased odds of BOT cancer. A history of previous tonsillectomy may play a role in OPSCC risk stratification when considered along with other covariates such as sexual history, smoking status, and age

Assessment of the Linkages and Leakages in a Cloud-Based Computing Collaboration among Construction Stakeholders

The uniqueness of the construction industry can be understood in the large volumes of information in terms of paper works, processes, and communication disseminated daily. The voluminous information requires close coordination which cloud based systems offer. The aim of this research is to assess the linkages and leakages in a cloud-based computing collaboration among construction stakeholders. A purposive sampling technique was used in selecting the participants of the study. A questionnaire based instrument was distributed to eighty (80) construction stakeholder in Lagos State, Nigeria. The data collected was analyzed using SPSS v.21. Statistical tools such as frequencies, stacked bars, mean scores, factor analysis, and analysis of variance (ANOVA) were used in the study. The result of the study revealed that construction stakeholders rarely utilize cloud-based technologies for their construction processes. Construction professionals that access cloud based technologies, do so with their smart mobile phones, laptops, and tablet. The study classified the leakages that exist in the use of cloud-based technologies as securitybased factors, cloud-based infrastructure factors, and cloud-based benefits deficiency based factors. In conclusion, the study revealed that the linkages in the use of cloudbased technologies include knowledge sharing, remote access of back-office activities and engendering collaboration among construction stakeholders. It was recommended that construction stakeholders should leverage on the benefits cloud-based technologies has to offer in today’s competitive economy. Construction stakeholdersshould be adequately informed on the available cloud-based computing technologies and the additions it can bring into the construction process. Cloud computing technology vendors should improve on the security and privacy features of the platform for adequate protection of building data

Effect of HPV on head and neck cancer patient survival, by region and tumor site: A comparison of 1362 cases across three continents

Objectives: To explore whether HPV-related biomarkers predict oropharyngeal squamous cell cancer (OPSCC) survival similarly across different global regions, and to explore their prognostic utility among non-oropharyngeal (non-OP) head and neck cancers. Methods: Data from 1362 head and neck SCC (HNSCC) diagnosed 2002–2011 was used from epidemiologic studies in: Brazil (GENCAPO study, n = 388), U.S. (CHANCE study, n = 472), and Europe (ARCAGE study, n = 502). Tumors were centrally tested for p16INK4a and HPV16 DNA (by PCR). Risk of mortality was examined using Cox proportional hazard models. Results: There were 517 OPSCC and 845 non-OP HNSCC. Cases were primarily male (81%), ever smokers (91%), with median age of 58 years and median follow-up of 3.1 years (IQR = 1.4–5.9). Among OPSCC, the risk of mortality was significantly lower among 184 HPV-related (i.e., p16+/HPV16+) compared to 333 HPV-unrelated (p16- and/or HPV16-) cases (HR = 0.25, 95%CI = 0.18–0.34). Mortality was reduced among HPV-related OPSCC cases from the U.S., Europe, and Brazil (each p ⩽ 0.01) and after adjustment, remained significantly reduced (aHR = 0.34, 95%CI = 0.24–0.49). Among non-OP HNSCC, neither p16 (aHR = 0.83, 95%CI = 0.60–1.14), HPV16 DNA (aHR = 1.20, 95%CI = 0.89–1.63), or p16+/HPV16+ (aHR = 0.59, 95%CI = 0.32–1.08) was a significantly predictor of mortality. When interaction was tested, the effect of HPV16/p16 was significantly different in OPSCC than non-OP HNSCC (p-interaction = 0.02). Conclusion: HPV-related OPSCCs had similar survival benefits across these three regions. Prognostic utility of HPV among non-OP HNSCC is limited so tumor HPV/p16 testing should not be routinely done among non-OP HNSCC

Prediction of survival of HPV16-negative, p16-negative oral cavity cancer patients using a 13-gene signature: A multicenter study using FFPE samples

Objectives: To WA the performance of an oral cancer prognostic 13-gene signature for the prediction of survival of patients diagnosed with HPV-negative and p16-negative oral cavity cancer. Materials and Methods: Diagnostic formalin-fixed paraffin-embedded oral cavity cancer tumor samples were obtained from the Fred Hutchinson Cancer Research Center/University of Washington, University of Calgary, University of Michigan, University of Utah, and seven ARCAGE study centers coordinated by the International Agency of Research on Cancer. RNA from 638 Human Papillomavirus (HPV)-negative and p16-negative samples was analyzed for the 13 genes using a NanoString assay. Ridge-penalized Cox regressions were applied to samples randomly split into discovery and validation sets to build models and evaluate the performance of the 13-gene signature in predicting 2-year oral cavity cancer-specific survival overall and separately for patients with early and late stage disease. Results: Among AJCC stage I/II patients, including the 13-gene signature in the model resulted in substantial improvement in the prediction of 2-year oral cavity cancer-specific survival. For models containing age and sex with and without the 13-gene signature score, the areas under the Receiver Operating Characteristic Curve (AUC) and partial AUC were 0.700 vs. 0.537 (p < 0.001), and 0.046 vs. 0.018 (p < 0.001), respectively. Improvement in predicting prognosis for AJCC stage III/IV disease also was observed, but to a lesser extent. Conclusions: If confirmed using tumor samples from a larger number of early stage oral cavity cancer patients, the 13-gene signature may inform personalized treatment of early stage HPV-negative and p16-negative oral cavity cancer patients

Clinical Case Definitions for Classification of Intrathoracic Tuberculosis in Children: An Update

Consensus case definitions for childhood tuberculosis have been proposed by an international expert panel, aiming to standardize the reporting of cases in research focusing on the diagnosis of intrathoracic tuberculosis in children. These definitions are intended for tuberculosis diagnostic evaluation studies of symptomatic children with clinical suspicion of intrathoracic tuberculosis, and were not intended to predefine inclusion criteria into such studies. Feedback from researchers suggested that further clarification was required and that these case definitions could be further improved. Particular concerns were the perceived complexity and overlap of some case definitions, as well as the potential exclusion of children with acute onset of symptoms or less severe disease. The updated case definitions proposed here incorporate a number of key changes that aim to reduce complexity and improve research performance, while maintaining the original focus on symptomatic children suspected of having intrathoracic tuberculosis. The changes proposed should enhance harmonized classification for intrathoracic tuberculosis disease in children across studies, resulting in greater comparability and the much-needed ability to pool study results

Clinical Case Definitions for Classification of Intrathoracic Tuberculosis in Children: An Update

Consensus case definitions for childhood tuberculosis have been proposed by an international expert panel, aiming to standardize the reporting of cases in research focusing on the diagnosis of intrathoracic tuberculosis in children. These definitions are intended for tuberculosis diagnostic evaluation studies of symptomatic children with clinical suspicion of intrathoracic tuberculosis, and were not intended to predefine inclusion criteria into such studies. Feedback from researchers suggested that further clarification was required and that these case definitions could be further improved. Particular concerns were the perceived complexity and overlap of some case definitions, as well as the potential exclusion of children with acute onset of symptoms or less severe disease. The updated case definitions proposed here incorporate a number of key changes that aim to reduce complexity and improve research performance, while maintaining the original focus on symptomatic children suspected of having intrathoracic tuberculosis. The changes proposed should enhance harmonized classification for intrathoracic tuberculosis disease in children across studies, resulting in greater comparability and the much-needed ability to pool study results