Association of neutrophil-to-lymphocyte ratio with severe radiation-induced mucositis in pharyngeal or laryngeal cancer patients: a retrospective study

Background: The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that informs clinical decisions regarding recurrence and overall survival in most epithelial cancers. Radiotherapy for head and neck cancer leads to mucositis in almost all patients and severe radiation-mucositis affects their quality of life (QOL). However, little is known about the NLR for severe mucositis. Therefore, this study aimed to show the association between the NLR and severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients.Methods: In this retrospective study, we determined the incidence of grade 3 mucositis in 99 patients who were receiving definitive radiotherapy or chemoradiotherapy (CRT) for hypopharyngeal or laryngeal cancer. We performed univariate and multivariate logistic regression analyses to investigate the characteristics of grade 3 mucositis. Kaplan–Meier curves and log-rank tests were used to evaluate the occurrence of grade 3 mucositis between two groups with high (NLR > 5) or low (NLR  5) prior to radiotherapy developed grade 3 mucositis more frequently than those with lower NLR during radiotherapy (p = 0.045).Conclusion: This study suggests that a higher NLR is a risk factor and predictor of severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients

Formation of a transdisciplinary community of practice in rural areas, with an interactive database of co-created knowledge: A case study in Noto, Japan

Many rural areas suffer from severe depopulation, and the absence of a university is one reason for outmigration. Where research and education are valued, however, such rural areas can attract scholars and students visiting from universities and other external institutions. Scholarly outputs of research, such as research articles and project reports, particularly those from community-based research (CBR), can themselves become an asset for use by local communities. We consider that CBR can contribute to asset-based community development (ABCD) when a transdisciplinary community of practice (TDCOP) emerges and drives the processes of collaborative creation and use of the knowledge. A particularly critical mechanism, which is currently lacking, is to allow the local community to collect knowledge outputs and make them easily available to interested actors within and outside of the community. We assume that a core tool in this mechanism is an interactive database. It can be equipped with a user interface, allowing enjoyable and active searches, and possibly a mechanism by which users themselves can contribute to gradual development of the database. We formed a study group of researchers and practitioners to conduct a case study in the Noto region of Japan. We identified the existing assets in Noto, including the knowledge created through CBR, and then collected and shared our own experiences and practices, as well as lessons learned from other regions in Japan, to explore the principles of designing a database. A CBR database should not only be a static inventory of past research, but also capable of facilitating new cycles of knowledge co-creation. With a comprehensive and easily accessible inventory of knowledge in place, we conclude that there is high potential in enabling CBR itself to be an asset, which can help achieve ABCD in rural communities

Lower limb perfusion during robotic-assisted laparoscopic radical prostatectomy evaluated by near-infrared spectroscopy: an observational prospective study

Abstract Background Decreased perfusion in the lower extremities is one of the several adverse effects of placing patients in a lithotomy or Trendelenburg position during surgery. This study aimed to evaluate the effects of patient positioning in lower limb perfusion patients undergoing robotic-assisted laparoscopic radical prostatectomy (RARP) using near-infrared spectroscopy (NIRS). Methods This observation study comprised 30 consenting males with American Society of Anaesthesiologists physical status classes I and II (age range, ≥20 to < 80 years). Regional saturation of oxygen measurements was obtained using an INVOS™ oximeter (Somanetics, Troy, MI, USA). A NIRS sensor was positioned on the surface of the skin at the mid-diaphyseal region of the calf muscles (the gastrocnemius and soleus), over the posterior compartment, in the right lower leg. Regional saturation of oxygen (rSO2) was sampled during the following time points: before and 5 min after induction of anaesthesia (T0,T1); 5 min after establishment of pneumoperitoneum in a 0° lithotomy position (T2); 5 min after a 25° Trendelenburg position (T3); 30, 60, 90 and 120 min after pneumoperitoneum in a Trendelenburg position (T4, T5, T6 and T7, respectively); after desufflation in a supine position (T8); and after tracheal extubation (T9). Results Lower limb perfusion evaluated by NIRS was increased after induction of anaesthesia and maintained during steep Trendelenburg positions in RARP patients with no risk for lower limb compartment syndrome (LLCS) (T0:65 ± 7.2%, T1:69 ± 6.1%, T2:70±:6.1%, T3:68 ± 6.7%, T4:66 ± 7.5%, T5:67 ± 6.9%, T6:68 ± 7.2%, T8:73 ± 7.2%, T9:71 ± 7.9%, respectively). Conclusions Lower limb perfusion evaluated by NIRS was maintained during the RARP procedure. Correct patient positioning and careful assessment of risk factors such as vascular morbidity could be important for the prevention of LLCS during RARP

Pleasant Stroke Touch on Human Back by a Human and a Robot

Pleasant touching is an important aspect of social interactions that is widely used as a caregiving technique. To address the problems resulting from a lack of available human caregivers, previous research has attempted to develop robots that can perform this kind of pleasant touch. However, it remains unclear whether robots can provide such a pleasant touch in a manner similar to humans. To investigate this issue, we compared the effect of the speed of gentle strokes on the back between human and robot agents on the emotional responses of human participants (n = 28). A robot or a human stroked on the participants’ back at two different speeds (i.e., 2.6 and 8.5 cm/s). The participants’ subjective (valence and arousal ratings) and physiological (facial electromyography (EMG) recorded from the corrugator supercilii and zygomatic major muscles and skin conductance response) emotional reactions were measured. The subjective ratings demonstrated that the speed of 8.5 cm/s was more pleasant and arousing than the speed of 2.6 cm/s for both human and robot strokes. The corrugator supercilii EMG showed that the speed of 8.5 cm/s resulted in reduced activity in response to both human and robot strokes. These results demonstrate similar speed-dependent modulations of stroke on subjective and physiological positive emotional responses across human and robot agents and suggest that robots can provide a pleasant touch similar to that of humans

Pleasant Stroke Touch on Human Back by a Human and a Robot

Pleasant touching is an important aspect of social interactions that is widely used as a caregiving technique. To address the problems resulting from a lack of available human caregivers, previous research has attempted to develop robots that can perform this kind of pleasant touch. However, it remains unclear whether robots can provide such a pleasant touch in a manner similar to humans. To investigate this issue, we compared the effect of the speed of gentle strokes on the back between human and robot agents on the emotional responses of human participants (n = 28). A robot or a human stroked on the participants&rsquo; back at two different speeds (i.e., 2.6 and 8.5 cm/s). The participants&rsquo; subjective (valence and arousal ratings) and physiological (facial electromyography (EMG) recorded from the corrugator supercilii and zygomatic major muscles and skin conductance response) emotional reactions were measured. The subjective ratings demonstrated that the speed of 8.5 cm/s was more pleasant and arousing than the speed of 2.6 cm/s for both human and robot strokes. The corrugator supercilii EMG showed that the speed of 8.5 cm/s resulted in reduced activity in response to both human and robot strokes. These results demonstrate similar speed-dependent modulations of stroke on subjective and physiological positive emotional responses across human and robot agents and suggest that robots can provide a pleasant touch similar to that of humans

A case of condyloma acuminatum of the bladder concurrently diagnosed with urothelial carcinoma

Introduction Condyloma acuminatum usually occurs in the external genitalia and rarely in the bladder mucosa. Here, we report a case of condyloma acuminatum of the bladder that was detected concurrently with urothelial carcinoma. Case presentation A 42‐year‐old man was referred to our urology department with positive urine cytology for urothelial carcinoma. Cystoscopy revealed a broad‐base nonpapillary bladder tumor. The patient underwent a transurethral resection of the bladder tumor. Pathological examination revealed urothelial carcinoma, high‐grade pT1, and concurrent resection of condyloma acuminatum. DNA was extracted from the paraffin‐embedded transurethral resection of the bladder tumor tissue specimens. HPV11 was detected in condylomas by PCR and in situ hybridization, whereas HPV was not detected in urothelial carcinomas. Conclusion We report a rare case of condyloma acuminatum of the bladder that was concurrently diagnosed with urothelial carcinoma from the same site