Characteristics, roles, and training problems of agricultural extension radio specialists in the United States with application of findings to a Thai situation

This combination survey, library and descriptive application type of study was done in the United States and related to Thailand for the purposes of: (1) gathering historical information regarding Extension radio work; (2) identifying some of the important characteristics, roles and training problems of Extension radio specialists in the United States; (3) exploring generally accepted approaches used by United States Extension radio specialists for presenting subject matter and teaching methods in agent induction and inservice training; (4) studying the situation with regard to Extension radio work in Thailand, and (5) applying, as nearly as possible, some principles and practices found to be useful in the United States Cooperative Extension radio specialist work as they might be relevant for use in Thailand. In the United States portion of the study, 32 of 54 states and other geographical area Extension radio specialists responded to a 1974 mail questionnaire. Characteristics of specialists in states respond ing were found to include the following: (1) most of the radio special-ists were employed by the Cooperative or Agricultural Extension Division of the state land grant institutions; (2) titles of Extension radio specialists varied in the states from Extension or Agricultural Editor to Radio and/or Television Specialist and/or Editor; (3) of 65 Extension radio specialists working in the 32 states responding, 41 were full-time radio employees, and 24 were part-time; (4) most radio specialists had at least the Master\u27s degree, the largest number of majors being in Agriculture and Communication; (5) the following average percents of Extension radio specialist staff time had been expanded in 1973. (a) 70 percent to radio production for broadcast stations, (b) 19 percent to radio production for county Extension staffs, (c) 9 percent to agent training, and (d) 2 percent to other work. Duties and responsibilities of radio specialists reportedly were: (1) determining agent radio-related training needs; (2) program pro-duction; and (3) maintaining good relations with radio stations. Some other duties were cooperating with other offices and program planning. Twenty-five states indicated that they provided induction and/or inservice training. They were selected for a special study of their practices, procedures and problems. The following important findings related to induction training: (1) writing for radio, radio interview ing and voice-delivery were three key subjects most frequently included; (2) specialist thinking and agent requests were most often listed as induction training determinants; (3) time limitation was the largest induction training major problem related by radio specialists; (4) most radio-related induction training was provided at state level; (5) radio specialists were most frequently the ones responsible for such training, (6) radio specialists and administrators usually were responsible for approval of training; (7) workshops and office vists were the most often mentioned primary Extension methods used for such training; (8) agent products and performance were most frequently listed as measures for training evaluation; (9) most state staffs planned to devote about the same time to training in 1974 that they had spent in 1973; (10) most states rated the adequacy of their 1973 training effort as fairly adequate ; (11) an average of 22 agents per state was trained in 1973 in 22 states, members ranging from 3 to 100 in numbers trained. The following points were made regarding inservice training: (1) writing for radio, nature of radio background, preparation of material, and voice-delivery were four key subjects most frequently included; (2) agent requests and agent plans of work were most often listed as primary inservice training determinants; (3) time limitation was the largest agent inservice training major problem; (4) most radio-related agent inservice training was provided at district level; (5) radio specialists were most frequently the ones responsible for such training; (6) district or area supervisors and administration usually were responsible for approval of training; (7) workshops were the most often mentioned primary Extension method used for such training; (8) agent products, participant evaluation and skill were most frequently listed as criteria or measures for training evaluation; (9) equal numbers of states rated the adequacy of their 1973 inservice training efforts as fairly adequate and not very adequate ; (10) most state staffs planned to devote about the same time to training in 1974 that they spent in 1973; (11) averages of 43 agents per state were trained in 1973 in 24 states, numbers trained ranging from 3 to 200 members. Concerning the Thai situation, it was found that changwad (similar to state) and amphor (similar to county) Extension worker radio-related induction or inservice training had not been conducted in 1973. However, the numbers of Extension workers at both levels had increased. Also, training in Agricultural communication was seen as being needed more and more. As a result of this study, some suggestions are made for induction and inservice training programs for Thai Extension workers. Such induction and inservice training efforts should help Extension agents, both new and experienced, leam how to produce effective radio programs aimed at farmers. Suggestions for use of findings and further research also were made

Complete Pathologic Response Following Multimodality Therapy for a Recurrent, High-Grade Phyllodes Tumor

Introduction: Phyllodes tumor is a rare mesenchymal tumor of the breast for which surgical resection is the primary therapy. Despite adequate surgical resection, local recurrence rates of up to 40% are observed in patients with high-grade tumors. The role of adjuvant radiation therapy and chemotherapy for phyllodes tumor to improve local and systemic control is not well established. However, several small studies have shown improvements in local control rates with adjuvant radiation therapy. The management of aggressive local phyllodes tumor recurrences can be a clinical challenge and multimodality therapy should be considered in these cases for optimal results.Case presentation: We present the case of a high-grade phyllodes tumor that recurred in the radiation field after adjuvant radiation therapy. The patient was treated with neoadjuvant hyperfractionated, accelerated radiotherapy in combination with hyperthermia and chemotherapy followed by radical surgical resection. A completed pathologic response was observed.Conclusion: This multimodality approach may be a successful treatment algorithm for high-grade tumors that reoccur in a prior radiation field

Adaptive immune signature in HER2-positive breast cancer in NCCTG (Alliance) N9831 and NeoALTTO trials

Breast cancer; Predictive markersCáncer de mama; Marcadores predictivosCàncer de mama; Marcadors predictiusTrastuzumab acts in part through the adaptive immune system. Previous studies showed that enrichment of immune-related gene expression was associated with improved outcomes in HER2-positive (HER2+) breast cancer. However, the role of the immune system in response to lapatinib is not fully understood. Gene expression analysis was performed in 1,268 samples from the North Central Cancer Treatment Group (NCCTG) N9831 and 244 samples from the NeoALTTO trial. In N9831, enrichment of CD45 and immune-subset signatures were significantly associated with improved outcomes. We identified a novel 17-gene adaptive immune signature (AIS), which was found to be significantly associated with improved RFS among patients who received adjuvant trastuzumab (HR 0.66, 95% CI 0.49–0.90, Cox regression model p = 0.01) but not in patients who received chemotherapy alone (HR 0.96, 95% CI 0.67–1.40, Cox regression model p = 0.97). This result was validated in NeoALTTO. Overall, AIS-low patients had a significantly lower pathologic complete response (pCR) rate compared with AIS-high patients (χ2 p < 0.0001). Among patients who received trastuzumab alone, pCR was observed in 41.7% of AIS-high patients compared with 9.8% in AIS-low patients (OR of 6.61, 95% CI 2.09–25.59, logistic regression model p = 0.003). More importantly, AIS-low patients had a higher pCR rate with an addition of lapatinib (51.1% vs. 9.8%, OR 9.65, 95% CI 3.24–36.09, logistic regression model p < 0.001). AIS-low patients had poor outcomes, despite receiving adjuvant trastuzumab. However, these patients appear to benefit from an addition of lapatinib. Further studies are needed to validate the significance of this signature to identify patients who are more likely to benefit from dual anti-HER2 therapy. ClinicalTrials.gov Identifiers: NCT00005970 (NCCTG N9831) and NCT00553358 (NeoALTTO).Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Numbers U10CA180882 and U24CA196171 (to the Alliance for Clinical Trials in Oncology); UG1CA233180, UG1CA232760, UG1CA233373, and U10CA180821. https://acknowledgments.alliancefound.org. Also supported in part by funds from the Department of Defense W81XWH-18-1-0562 and −0563 and W81XWH-16-1-0265 and 0266, as well as the Breast Cancer Research Foundation (BCRF-19-161), Bankhead-Coley Research Program (6BC05), Susan G. Komen Foundation (SAC190091), and the DONNA Foundation. The content is solely the authors’ responsibility and does not necessarily represent the official views of the National Institutes of Health. Genentech/Roche supplied trastuzumab for both trials. Presented at the Spotlight Session at San Antonio Breast Cancer Symposium 2016 and the ASCO Annual Meeting 2018. Portions of this paper have been published in abstract form: Journal of Clinical Oncology 36, no. 15_suppl (May 20, 2018) 577

Mitosis in circulating tumor cells stratifies highly aggressive breast carcinomas.

BACKGROUND: Enumeration of circulating tumor cells (CTCs) isolated from the peripheral blood of breast cancer patients holds promise as a clinically relevant, minimally invasive diagnostic test. However, CTC utility has been limited as a prognostic indicator of survival by the inability to stratify patients beyond general enumeration. In comparison, histological biopsy examinations remain the standard method for confirming malignancy and grading malignant cells, allowing for cancer identification and then assessing patient cohorts for prognostic and predictive value. Typically, CTC identification relies on immunofluorescent staining assessed as absent/present, which is somewhat subjective and limited in its ability to characterize these cells. In contrast, the physical features used in histological cytology comprise the gold standard method used to identify and preliminarily characterize the cancer cells. Here, we superimpose the methods, cytologically subtyping CTCs labeled with immunohistochemical fluorescence stains to improve their prognostic value in relation to survival. METHODS: In this single-blind prospective pilot study, we tracked 36 patients with late-stage breast cancer over 24 months to compare overall survival between simple CTC enumeration and subtyping mitotic CTCs. A power analysis (1-β = 0. 9, α = 0.05) determined that a pilot size of 30 patients was sufficient to stratify this patient cohort; 36 in total were enrolled. RESULTS: Our results confirmed that CTC number is a prognostic indicator of patient survival, with a hazard ratio 5.2, p = 0.005 (95 % CI 1.6-16.5). However, by simply subtyping the same population based on CTCs in cytological mitosis, the hazard ratio increased dramatically to 11.1, p \u3c 0.001 (95 % CI 3.1-39.7). CONCLUSIONS: Our data suggest that (1) mitotic CTCs are relativity common in aggressive late-stage breast cancer, (2) mitotic CTCs may significantly correlate with shortened overall survival, and (3) larger and more defined patient cohort studies are clearly called for based on this initial pilot study

Myeloid sarcomas: a histologic, immunohistochemical, and cytogenetic study

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Melatonin affects the dynamic steady-state equilibrium of estrogen sulfates in human umbilical vein endothelial cells by regulating the balance between estrogen sulfatase and sulfotransferase

Melatonin is known to reduce the growth of endocrine-responsive breast cancers by interacting with estrogen signaling pathways. Estrogens play an important role in breast cancer, but also in various types of tissues, including vascular tissue. Estrogen sulfatase (STS) converts inactive estrogen sulfates into active estrogens, whereas estrogen sulfotransferase (EST) sulfonates estrogens to estrogen sulfates. Therefore, STS and EST are considered to be involved in the regulation of local estrogen levels in hormone‑dependent tumors and in non-pathologic tissues, such as those of the vascular system. Estrogens have a major impact on the vasculature, influencing vascular function, the expression of adhesion proteins, angiogenesis and the inflammatory state. In this study, we investigated the status of STS and EST in human umbilical vein endothelial cells (HUVECs) and the modulatory effects of melatonin. Both STS and EST were highly expressed in the HUVECs. The enzymatic activity correlated with the expression levels in these cells. Our findings also demonstrated that melatonin, at physiological concentrations, modulated the synthesis and transformation of biologically active estrogens in HUVECs through the inhibition of STS activity and expression, and the stimulation of EST activity and expression. Since melatonin decreased the STS levels and increased the EST levels, it modified the dynamic steady‑state equilibrium of estrogen sulfates by increasing the inactive estrogen levels and decreasing the active estrogen levels. Therefore, melatonin may modulate the known different biological actions of estrogens in endothelial cells, as well as in estrogen‑dependent tumors and non-pathologic tissues

Transcriptional properties of human NANOG1 and NANOG2 in acute leukemic cells

Transcripts of NANOG and OCT4 have been recently identified in human t(4;11) leukemia and in a model system expressing both t(4;11) fusion proteins. Moreover, downstream target genes of NANOG/OCT4/SOX2 were shown to be transcriptionally activated. However, the NANOG1 gene belongs to a gene family, including a gene tandem duplication (named NANOG2 or NANOGP1) and several pseudogenes (NANOGP2-P11). Thus, it was unclear which of the NANOG family members were transcribed in t(4;11) leukemia cells. 5′-RACE experiments revealed novel 5′-exons of NANOG1 and NANOG2, which could give rise to the expression of two different NANOG1 and three different NANOG2 protein variants. Moreover, a novel PCR-based method was established that allows distinguishing between transcripts deriving from NANOG1, NANOG2 and all other NANOG pseudogenes (P2–P11). By applying this method, we were able to demonstrate that human hematopoietic stem cells and different leukemic cells transcribe NANOG2. Furthermore, we functionally tested NANOG1 and NANOG2 protein variants by recombinant expression in 293 cells. These studies revealed that NANOG1 and NANOG2 protein variants are functionally equivalent and activate a regulatory circuit that activates specific stem cell genes. Therefore, we pose the hypothesis that the transcriptional activation of NANOG2 represents a ‘gain-of-stem cell function’ in acute leukemia

Enzymatic Extraction of Fucoxanthin from Brown Seaweeds

Brown seaweeds contain a number of bioactive compounds. The xanthophyll, fucoxanthin, has in vivo efficacy against disorders such as type 2 diabetes, obesity and cancer. Organic solvents are traditionally employed to extract fucoxanthin, but carry a toxic chemical and environmental burden. The aim of this study was to optimise a fucoxanthin extraction method using enzymes, water, low-temperature dehydration and mechanical blending, to produce yields comparable to those achieved with an organic solvent (acetone). Response surface methodology was applied, using Fucus vesiculosus as a model species. A fucoxanthin yield of 0.657 mg g-1 (dry mass) was obtained from F. vesiculosus blade using the enzymatic method, equivalent to 94% of the acetone-extracted yield. Optimum extraction parameters were determined to be enzyme-to-water ratio 0.52%, seaweed-to-water ratio 5.37% and enzyme incubation time 3.05 h. These findings may be applied to the development of value-added nutraceutical products from seaweed

Long-term cardiac outcomes of patients with HER2-positive breast cancer treated in the adjuvant lapatinib and/or trastuzumab Treatment Optimization Trial

Background Cardiotoxicity is the most significant adverse event associated with trastuzumab (T), the main component of HER2-positive breast cancer (BC) treatment. Less is known about the cardiotoxicity of dual HER2 blockade with T plus lapatinib (L), although this regimen is used in the metastatic setting. Methods This is a sub-analysis of the ALTTO trial comparing adjuvant treatment options for patients with early HER2-positive BC. Patients randomised to either T or concomitant T + L were eligible. Cardiac events (CEs) rates were compared according to treatment arm. Results With 6.9 years of median follow-up (FU) and 4190 patients, CE were observed in 363 (8.6%): 166 (7.9%) of patient in T + L arm vs. 197 (9.3%) in T arm (OR = 0.85 [95% CI, 0.68-1.05]). During anti-HER2 treatment 270 CE (6.4%) occurred while 93 (2.2%) were during FU (median time to onset = 6.6 months [IQR = 3.4-11.7]). While 265 CEs were asymptomatic (73%), 94 were symptomatic (26%) and four were cardiac deaths (1%). Recovery was observed in 301 cases (83.8%). Identified cardiac risk factors were: baseline LVEF 64%, OR 3.1 [95% CI 1.54-6.25]), diabetes mellitus (OR 1.85 [95% CI 1.25-2.75]), BMI > 30 kg/m(2) (vs = 240 mg/m(2) (OR 1.36 [95% CI 1.01-1.82]) and of epirubicin >= 480 mg/m(2) (OR 2.33 [95% CI 1.55-3.51]). Conclusions Dual HER2 blockade with T + L is a safe regimen from a cardiac perspective, but cardiac-focused history for proper patient selection is crucial.Experimentele farmacotherapi

Natural history of stage II/III breast cancer, bone metastasis and the impact of adjuvant zoledronate on distribution of recurrences

Aim The prognosis for women with breast cancer has improved markedly over recent decades. However, mortality from breast cancer remains high and, for those developing metastatic disease, curative therapy is not possible. Here, we report the frequency and distribution of disease recurrence(s) in a large population of women with AJCC stage II/III breast cancer and evaluate the impact of adjuvant treatment with the bisphosphonate zoledronate on clinical outcomes. Patients and methods In the context of the AZURE study (ISRCTN7981382), 3359 patients with histologically confirmed stage II/III breast cancer were randomised to receive standard adjuvant treatment ± zoledronate for five years. Patients were followed up for 10 years and all patients with recurrent disease in that time identified. The site of first recurrence, the first distant recurrence site(s) and bone metastasis at any time were recorded and outcomes in the control and zoledronate treatment groups compared. Survival after recurrence was also evaluated. Results In the study population as a whole, disease recurrence at a median follow-up of 117 months occurred in 1010/3359 (30%) women with a relatively constant rate of disease relapse of around 3% per year. 727 (72%) first recurrences were at distant sites, 178 locoregional (18%) and 105 (10%) both locoregional and distant relapses occurred synchronously. Bone was the most frequent first recurrence site occurring in 463 (14%) of all patients and was the only distant metastatic site in 265 (7.9%). 69% of the control group who developed recurrent disease had bone metastases identified. Bone metastases were more frequent in those with oestrogen receptor (ER) positive disease and recurrences overall, especially at visceral sites, were more likely with ER negative disease. Zoledronate reduced bone metastases in both ER subgroups but increased the proportion with extra-skeletal metastases, particularly in women who were not definitely postmenopausal at study entry. Adjuvant zoledronate also reduced bone metastases after recurrence at an extra-skeletal site. Conclusions This analysis provides contemporary information on the frequency and pattern of recurrences after treatment for stage II/III breast cancer that may be of value in planning future adjuvant trials. It confirms the ongoing importance of bone metastases and describes in detail for the first time the effects of adjuvant zoledronate on the pattern of metastasis