Induction chemotherapy with dose-modified docetaxel, cisplatin, and 5-fluorouracil in Asian patients with borderline resectable or unresectable head and neck cancer

BackgroundSignificant ethnic differences in susceptibility to the effects of chemotherapy exist. Here, we retrospectively analyzed the safety and efficacy of induction chemotherapy (ICT) with dose-modified docetaxel, cisplatin, and 5-fluorouracil (TPF) in Asian patients with borderline resectable or unresectable head and neck squamous cell carcinoma (HNSCC).MethodsBased on the incidence of adverse events that occurred during daily practice, TPF90 (90% of the original TPF dosage; docetaxel 67.5 mg/m2 on Day 1, cisplatin 67.5 mg/m2 on Day 1, and 5-fluorouracil 675 mg/m2 on Days 1–5) was used for HNSCC patients who were scheduled to receive ICT TPF.ResultsBetween March 2011 and May 2014, 52 consecutive patients with borderline resectable or unresectable HNSCC were treated with ICT TPF90 followed by concurrent chemoradiotherapy. Forty-four patients (84.6%) received at least three cycles of ICT TPF90. The most commonly observed Grade 3–4 adverse events included neutropenia (35%), anemia (25%), stomatitis (35%), diarrhea (16%), and infections (13.5%). In an intention-to-treat analysis, the complete and partial response rates after ICT TPF90 were 13.5% and 59.6%, respectively. The complete and partial response rates following radiotherapy and salvage surgery were 42.3% and 25.0%, respectively. The estimated 3-year overall survival and progression-free survival rates were 41% [95% confidence interval (CI): 25–56%] and 23% (95% CI: 10–39%), respectively. The observed median overall survival and progression-free survival were 21.0 months (95% CI: 13.3–28.7 months) and 16.0 months (95% CI: 10.7–21.3 months), respectively.ConclusionTPF90 is a suitable option for Asian patients with borderline resectable or unresectable HNSCC who are scheduled for ICT

Impact of cardiac arrest centers on the survival of patients with nontraumatic out‐of‐hospital cardiac arrest : a systematic review and meta‐analysis

Background The role of cardiac arrest centers (CACs) in out‐of‐hospital cardiac arrest care systems is continuously evolving. Interpretation of existing literature is limited by heterogeneity in CAC characteristics and types of patients transported to CACs. This study assesses the impact of CACs on survival in out‐of‐hospital cardiac arrest according to varying definitions of CAC and prespecified subgroups. Methods and Results Electronic databases were searched from inception to March 9, 2021 for relevant studies. Centers were considered CACs if self‐declared by study authors and capable of relevant interventions. Main outcomes were survival and neurologically favorable survival at hospital discharge or 30 days. Meta‐analyses were performed for adjusted odds ratio (aOR) and crude odds ratios. Thirty‐six studies were analyzed. Survival with favorable neurological outcome significantly improved with treatment at CACs (aOR, 1.85 [95% CI, 1.52–2.26]), even when including high‐volume centers (aOR, 1.50 [95% CI, 1.18–1.91]) or including improved‐care centers (aOR, 2.13 [95% CI, 1.75–2.59]) as CACs. Survival significantly increased with treatment at CACs (aOR, 1.92 [95% CI, 1.59–2.32]), even when including high‐volume centers (aOR, 1.74 [95% CI, 1.38–2.18]) or when including improved‐care centers (aOR, 1.97 [95% CI, 1.71–2.26]) as CACs. The treatment effect was more pronounced among patients with shockable rhythm ( P =0.006) and without prehospital return of spontaneous circulation ( P =0.005). Conclusions were robust to sensitivity analyses, with no publication bias detected. Conclusions Care at CACs was associated with improved survival and neurological outcomes for patients with nontraumatic out‐of‐hospital cardiac arrest regardless of varying CAC definitions. Patients with shockable rhythms and those without prehospital return of spontaneous circulation benefited more from CACs. Evidence for bypassing hospitals or interhospital transfer remains inconclusive

Development of a deep-sea cushion star, Pteraster tesselatus

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HISTOLOGY OF THE PYLORIC CAECA AND ITS CHANGES DURING BROODING AND STARVATION IN A STARFISH, LEPTASTERIAS HEXACTIS

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BROODING BEHAVIOR OF A SIX-RAYED STARFISH, LEPTASTERIAS HEXACTIS

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Distribution and dispersal of early juvenile snails: Effectiveness of intertidal microhabitats as refuges and food sources

In Barkley Sound, British Columbia, Canada, newly hatched Nucella emarginata, a direct developing prosobranch gastropod, are almost exclusively located within 3 structurally complex microhabitats: the filamentous algae Cladophora columbiana, clusters of mussels Mytilus, and dense assemblages of the barnacle Semibalanus cariosus. When exposed to desiccation or predators for 4 to 5 h, mortality of hatchlings located in these microhabitats (1.7 to 36% mortality) was considerably lower than for individuals on open surfaces (99 to 100%). Also, food (prey species) in C. columbiana, mussel clusters, and S. cariosus microhabitats was more abundant but of similar energetic value to that on open rock surfaces. The microhabitats used by early juvenile N. emarginata thus provide the double advantage of a considerably reduced risk of mortality and abundant prey. The means by which hatchlings disperse after emerging from their egg capsules were established by laboratory observations and by deployment of collectors in the field. Hatchlings do not actively initiate dispersal by drifting in the water column. Crawling is the usual means of travelling from the capsule to protective microhabitats, with hatchling crawling speed averaging only 3.7 mm/min on smooth rock surfaces in the laboratory. The abundance and distribution of microhabitats that protect early juveniles could therefore be important determinants of the local abundance and distribution of N. emarginata populations. The use of protective microhabitats may be the key to survival through the vulnerable early juvenile period in many benthic marine organisms

DEVELOPMENT AND JUVENILE GROWTH OF THE SEA ANEMONE, TEALIA CRASSICORNIS

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