Patient Concerns Inventory for head and neck cancer: Brazilian cultural adaptation

Objective: The purpose of this study was to translate, culturally validate and evaluate the Patients Concerns Inventory - Head and Neck (PCI- H&N) in a consecutive series of Brazilian patients. Methods: This study included adult patients treated for upper aerodigestive tract (UADT) cancer. The translation and cultural adaptation of the PCI–H&N followed internationally accepted guidelines and included a pretest sample of patients that completed the first Brazilian-Portuguese version of the PCI. The use/feasibility/acceptability of the PCI was tested subsequently in a consecutive series of UADT cancer patients that completed the final Brazilian-Portuguese version of the PCI and a Brazilian-Portuguese version of the University of Washington Quality of Life Questionnaire (UW-QOL). Associations between physical and socio emotional composite scores from the UW-QOL and PCI were analyzed. Results: Twenty patients participated in the pretest survey (translation and cultural adaptation process), and 84 patients were analysed in the cultural validation study. Issues most selected were: fear of cancer returning, dry mouth, chewing/eating, speech/voice/being understood, swallowing, dental health/teeth, anxiety, fatigue/tiredness, taste and fear of adverse events. The three specialists most selected were speech therapist, dentist and psychologist. Statistically significant relationships between PCI and UW-QOL were found. Conclusions: The translation and cultural adaptation of the PCI for Brazilian-Portuguese language was successful, and the results demonstrate its feasibility and usefulness, making this a valuable tool for use within the Brazilian H&N cancer population

Population Structure and Exploitation of Three Commercial Tree Species in Nguru ya Ndege Forest Reserve, Morogoro – Tanzania

Forests in tropical environments are unstable and hardly maintain fixed climax species composition over long periods. They are victims of modifications by variety of factors including human influences that result in long lasting disturbances. Having observed this, we investigated the population structure and rate of exploitation for three commercial tree species namely, Dalbergia melanoxylon, Pterocarpus angolensis and Afzelia quanzensis in Nguru ya Ndege Forest Reserve. Objectives were to determine the density, DBH distribution and the harvesting rate. We employed simple random procedure to select sampling points, where a map of the reserve was used to divide the study area into 100 equal grids. Fifty grids were then picked randomly, and within these grids, 20 by 20 m quadrats were established for counting stumps and trees with DBH ≥ 4 cm. In addition, saplings with DBH of ≤ 4 cm were counted inside 5 by 5 m quadrats placed within the 20 by 20 m quadrats. Results showed that, the density of P. angolensis was 19 stems/ha, A. quanzensis 8 stems/ha and D. melanoxylon 3.1 stems/ha. DBH graphs showed characteristic inversed J shapes for P. angolensis and A. quanzensis, but broken pattern for D.melanoxylon. Harvesting rates (stumps/ha) was 4.5 for A. quanzensis, 4.0 for P. angolensis and 1 for D. melanoxylon. We concluded that, all target species were found facing harvesting pressure, with the population structure of D. melanoxylon being disturbed. We recommended that harvest of trees in the reserve should be controlled.Keywords: Density, DBH distribution, Illegal harvest, Tropic

Wildlife-Based Domestic Tourism In Tanzania: Experiences From Northern Tourist Circuit

It is believed that for tourism industry to become successful, domestic, and international tourism should complement each other. But domestic tourism in many developing countries is nearly non-existent, with local residents mainly visiting friends and relatives. The study to examine characteristics and factors affecting domestic tourism was carried out in northern Tanzania tourist circuit. Specifically the study sought to determine the characteristics of Tanzanians who mostly visit the protected areas; to identify and assess factors affecting domestic tourism; and different factors that hinder growth of domestic tourism. A sample of 322 respondents was interviewed. Primary data was collected through questionnaires, focus group discussions, informal discussion; and secondary data was obtained from tourists visiting reports, and statistics. Data was analysed for descriptive statistics. The results obtained revealed that: More men visited wildlife protected areas than women. The age group of 26 – 37 was the most active group in visiting protected areas. Low financial income was indicated as the main constraint (77.0%) affecting the growth of domestic tourism, followed by means of communication and inadequate information (71.8%). It is recommended that, the Ministry of Natural Resources and Tourism need more plans, efforts, and combination of approaches in promoting and marketing domestic tourism.Key words: Domestic tourism, local communities, northern circuit, Tanzania, wildlife protected area

Patients’ experience of recurrent/metastatic head and neck squamous cell carcinoma and their perspective on the EORTC QLQC30 and QLQ-H&N35 questionnaires: a qualitative study

Abstract Background Head and neck squamous cell carcinoma (HNSCC) and its associated treatments may affect all aspects of patients’ health-related quality of life (HRQoL). Although the EORTC QLQ-H&N35 is regularly administered to patients with HNSCC, there is a paucity of studies re-assessing the conceptual relevance of this patient-reported outcome (PRO) measure from a patient perspective. Furthermore, the content validity of the EORTC QLQ-C30 has not been widely documented in patients with recurrent and/or metastatic HNSCC. The objectives of this study were to understand patients’ experiences of recurrent/metastatic HNSCC and its treatments, and to evaluate the conceptual relevance and acceptability of the EORTC QLQ-C30 and QLQ-H&N35 from a patient perspective for use in clinical trials. Methods A literature review and clinician interviews were conducted to inform in-depth semi-structured telephone interviews with US patients who had received treatment for recurrent and/or metastatic HNSCC in the preceding 12 months. Interview transcripts were analysed thematically using ATLAS.ti v7; patient quotes were coded to identify concepts and themes to develop a conceptual model of HNSCC experience. Results Fourteen patients were interviewed (71% male, aged 35–84 years). Patients reported few symptoms pre-diagnosis including neck lump/swelling (n = 7/14, 50%) and/or difficulty swallowing (n = 3/14, 21%). Treatments generally comprised surgery and chemotherapy and/or radiotherapy. A number of side effects from all treatments were reported. Numbness, difficulty speaking and pain were the most reported side effects of surgery (n = 4/8, 50%); weight loss and fatigue were the most reported side effects of chemotherapy and/or radiotherapy (n = 8/13, 61%). All side effects negatively impacted patients’ HRQoL. Patients generally found the QLQ-C30 and QLQ H&N35 content to be understandable and conceptually relevant; excessive mucous production and neuropathic symptoms were among the suggested additions. Conclusions HNSCC and its diverse symptoms and treatments have a negative impact on many aspects of patients’ lives. A number of reported symptoms including difficulty speaking and swallowing, localised pain and fatigue may be important for treatment benefit evaluation in clinical trials from a patient perspective. The QLQ-C30 and QLQ-H&N35 are generally relevant and suitable for use in clinical trials. However, some items could be amended/added to ensure conceptual comprehensiveness of these measures

Treatments and Predictors of Mortality for Carbapenem-Resistant Gram-Negative Bacilli Infections in Malaysia: A Retrospective Cohort Study

This study evaluated the treatments, mortality rate and patient-related factors associated with mortality. This is a retrospective study involving hospitalised patients with infections caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) in a tertiary hospital in Malaysia from January 2018 to June 2020. A clinical pharmacist reviewed patients’ electronic records and collected the data according to a pre-designed form. Data were analysed using both descriptive and inferential tests. The study included 145 patients with CR-GNB infections including 77, 40 and 28 Acinetobacter baumannii, enterobacteriaceae and Pseudomonas aeruginosa, respectively. The mean age was 57.9 ± 15.8 years. Pneumonia (40.7%) and bacteremia (25.5%) were the most common infections. Meropenem (24.7%) and piperacillin-tazobactam (20.4%) were the most commonly used empiric antibiotics while colistin (63.3%) and amikacin (8.3%) were the most common definitive antibiotics. The mean duration before active antibiotics was 4.6 ± 3.3 days. Overall, the in-hospital mortality rate was 41.4%. Multivariate logistic regression analysis showed that intensive care unit (ICU) admission (adjusted odds ratio (AOR): 5.201; 95% confidence interval (CI): 1.603–16.872; p = 0.006), sepsis/septic shock (AOR: 3.430; 95% CI: 1.021–11.522; p = 0.049) and elevated serum creatinine (AOR: 2.752; 95% CI: 1.005–7.536; p = 0.049) were independently associated with mortality. The mortality rate among patients with CR-GNB infection is high. A high rate of inappropriate antibiotic use was observed, including combination antibiotic therapy and delays in starting active antibiotics. Mortality was significantly associated with ICU admission, sepsis/septic shock and elevated serum creatinine

Cancers attributable to overweight and obesity from 2012 to 2014 in Nigeria: A population-based cancer registry study

Background: Overweight and obesity are known risk factors for chronic diseases including cancers. In this study, we evaluated the age standardized incidence rates (ASR) and proportion of cancers attributable to overweight and obesity in Nigeria. Methods: We obtained incidence data from the databases of two population-based cancer registries (PBCRs) in Nigeria (Abuja and Enugu cancer registries), on cancer site for which there is established evidence of an association with overweight or obesity based on the International Agency for Research on Cancer (IARC) and the World Cancer Research Fund (WCRF) classification. We analyzed the data using population attributable fraction (PAF) for overweight or obesity associated cancers calculated using prevalence data and relative risk estimates in previous studies. Results: The two PBCRs reported 4,336 new cancer cases (ASR 113.9 per 100,000) from 2012 to 2014. Some 21% of these cancers were associated with overweight and obesity. The ASR for overweight and obesity associated cancers was 24.5 per 100,000; 40.7 per 100,000 in women and 8.2 per 100,000 in men. Overall, only 1.4% of incident cancers were attributable to overweight and obesity. The ASR of cancers attributable to overweight and obesity was 2.0 per 100,000. Postmenopausal breast cancer was the most common cancer attributable to overweight and obesity (n = 25; ASR 1.2 per 100,000). Conclusion: Our results suggest that a small proportion of incident cancer cases in Nigeria are potentially preventable by maintaining normal body weight. The burden of cancer attributed to overweight and obesity in Nigeria is relatively small, but it may increase in future

Cancers attributable to alcohol consumption in Nigeria: 2012–2014

introduction: Alcohol consumption has been identified as a risk factor for many cancers but less attention has been paid to the fraction of those cancers that are attributable to alcohol consumption. In this study, we evaluated the incidence and population attributable fraction (PAF) of cancers associated with alcohol consumption in Nigeria. Methods: We obtained data on incidence of cancers from two population-based cancer registries (PBCRs) in Nigeria and identified cancer sites for which there is strong evidence of an association with alcohol consumption based on the International Agency for Research on Cancer Monograph 100E. We computed the PAF for each cancer site by age and sex, using prevalence and relative risk estimates from previous studies. results: Between 2012 and 2014 study period, the PBCRs reported 4,336 cancer cases of which 1,627 occurred in males, and 2,709 occurred in females. Of these, a total of 1,808 cancer cases, 339 in males and 1,469 in females, were associated with alcohol intake. The age standardized incidence rate (ASR) of alcohol associated cancers was 77.3 per 100,000. Only 4.3% (186/4,336) of all cancer cases or 10.3% (186/1,808) of alcohol associated cancers were attributable to alcohol consumption. Some 42.5% (79/186) of these cancers occurred in males while 57.5% (107/186) occurred in females. The ASR of cancers attributable to alcohol in this population was 7.2 per 100,000. The commonest cancers attributable to alcohol consumption were cancers of the oral cavity and pharynx in men and cancer of the breast in women. conclusion: Our study shows that 4.3% of incident cancers in Nigeria can be prevented by avoiding alcohol consumption. While the incidence of cancers associated with alcohol intake is high, the proportion attributable to alcohol consumption is much lower suggesting that the number of cancers that may be prevented by eliminating alcohol intake in this population is relatively low

Heatwave vulnerability of large metropolitans in Bangladesh: An evaluation

Data availability: Data will be made available on request.Supplementary material is available online at: https://www.sciencedirect.com/science/article/pii/S119510362400020X?via%3Dihub#sec0155 .Heatwaves pose a significant risk to human society, and assessing vulnerability at the local scale is challenging due to the multifaceted nature of contributing factors. This study focuses on evaluating the heatwave vulnerability of five major cities in Bangladesh: Chittagong, Dhaka, Khulna, Rajshahi, and Sylhet. Heatwave vulnerability index (HVI) was estimated, integrating exposure, sensitivity, and adaptive capacity components. Time-series data from the Moderate Resolution Imaging Spectroradiometer (MODIS) for land surface temperature (LST) spanning 2000–2019 served as the primary dataset. The HVI calculation employed a principal component analysis method. The spatial distribution of the resulting HVI across five metropolitan areas were evaluated by estimating spatial autocorrelation and identifying clusters and hot spots in vulnerable areas. The findings revealed that urban centers characterized by extensive built-up areas exhibited higher exposure to urban heat compared to their surroundings. Dhaka, the capital, recorded the highest mean annual LST, while Sylhet registered the lowest. Rajshahi and Sylhet stood out for having the largest percentage of heat-exposed and sensitive areas, respectively. Sylhet also had the highest percentage of heat-vulnerable areas, reaching 63 %, whereas Dhaka had the highest number of vulnerable individuals, totaling 12.5 million. The findings also suggested that augmenting urban green and blue infrastructures holds potential for mitigating the adverse impacts of heatwaves. The methodology and outcomes of this study provide a valuable foundation for devising heatwave adaptation strategies not only in Bangladesh but also in other regions facing similar challenges.Directorate of Research and Extension (DRE) of Chittagong University of Engineering and Technology (CUET) [grant number - CUET/DRE/2021–22/URP/011]

Insecticide resistance in the sand fly, Phlebotomus papatasi from Khartoum State, Sudan

<p>Abstract</p> <p>Background</p> <p><it>Phlebotomus papatasi </it>the vector of cutaneous leishmaniasis (CL) is the most widely spread sand fly in Sudan. No data has previously been collected on insecticide susceptibility and/or resistance of this vector, and a first study to establish a baseline data is reported here.</p> <p>Methods</p> <p>Sand flies were collected from Surogia village, (Khartoum State), Rahad Game Reserve (eastern Sudan) and White Nile area (Central Sudan) using light traps. Sand flies were reared in the Tropical Medicine Research Institute laboratory. The insecticide susceptibility status of first progeny (F1) of <it>P. papatasi </it>of each population was tested using WHO insecticide kits. Also, <it>P. papatasi </it>specimens from Surogia village and Rahad Game Reserve were assayed for activities of enzyme systems involved in insecticide resistance (acetylcholinesterase (AChE), non-specific carboxylesterases (EST), glutathione-S-transferases (GSTs) and cytochrome p450 monooxygenases (Cyt p450).</p> <p>Results</p> <p>Populations of <it>P. papatasi </it>from White Nile and Rahad Game Reserve were sensitive to dichlorodiphenyltrichloroethane (DDT), permethrin, malathion, and propoxur. However, the <it>P. papatasi </it>population from Surogia village was sensitive to DDT and permethrin but highly resistant to malathion and propoxur. Furthermore, <it>P. papatasi </it>of Surogia village had significantly higher insecticide detoxification enzyme activity than of those of Rahad Game Reserve. The sand fly population in Surogia displayed high AChE activity and only three specimens had elevated levels for EST and GST.</p> <p>Conclusions</p> <p>The study provided evidence for malathion and propoxur resistance in the sand fly population of Surogia village, which probably resulted from anti-malarial control activities carried out in the area during the past 50 years.</p

Selective Induction of Cell Death in Melanoma Cell Lines through Targeting of Mcl-1 and A1

Melanoma is an often fatal form of skin cancer which is remarkably resistant against radio- and chemotherapy. Even new strategies that target RAS/RAF signaling and display unprecedented efficacy are characterized by resistance mechanisms. The targeting of survival pathways would be an attractive alternative strategy, if tumor-specific cell death can be achieved. Bcl-2 proteins play a central role in regulating survival of tumor cells. In this study, we systematically investigated the relevance of antiapoptotic Bcl-2 proteins, i.e., Bcl-2, Bcl-xL, Bcl-w, Mcl-1, and A1, in melanoma cell lines and non-malignant cells using RNAi. We found that melanoma cells required the presence of specific antiapoptotic Bcl-2 proteins: Inhibition of Mcl-1 and A1 strongly induced cell death in some melanoma cell lines, whereas non-malignant cells, i.e., primary human fibroblasts or keratinocytes were not affected. This specific sensitivity of melanoma cells was further enhanced by the combined inhibition of Mcl-1 and A1 and resulted in 60% to 80% cell death in all melanoma cell lines tested. This treatment was successfully combined with chemotherapy, which killed a substantial proportion of cells that survived Mcl-1 and A1 inhibition. Together, these results identify antiapoptotic proteins on which specifically melanoma cells rely on and, thus, provide a basis for the development of new Bcl-2 protein-targeting therapies