Cutaneous Head and Neck Squamous Cell Carcinoma with Regional Metastases: The Prognostic Importance of Soft Tissue Metastases and Extranodal Spread

Extranodal spread (ENS) is an established adverse prognostic factor in metastatic cutaneous squamous cell carcinoma (cSCC); however, the clinical significance of soft tissue metastases (STM) is unknown. The aim of this study was to evaluate the prognosis of patients with STM from head and neck cSCC, and to compare this with that of node metastases with and without ENS. Patients with cSCC metastatic to the parotid and/or neck treated by primary surgical resection between 1987 and 2007 were included. Metastatic nodes > 3 cm in size were an exclusion criterion. A Cox proportional hazard model was used to determine the effect of STM adjusting for other relevant prognostic factors. The population included 164 patients with a median follow-up of 26 months. There were 8 distant and 37 regional recurrences. There were 22 were cancer-specific deaths, and 29 patients died. STM was a significant predictor of reduced overall (hazard ratio 3.3; 95% confidence interval 1.6-6.4; P = 0.001) and disease-free survival (hazard ratio 2.4; 95% confidence interval 1.4-4.1; P = 0.001) when compared to patients with node disease with or without ENS. After adjusting for covariates, STM and number of involved nodes were significant independent predictors of overall and disease-free survival. In metastatic cSCC of the head and neck, the presence of STM is an independent predictor of reduced survival and is associated with a greater adverse effect than ENS alone

Active case finding for rheumatic fever in an endemic country

Background: Despite the high burden of rheumatic heart disease in sub‐Saharan Africa, diagnosis with acute rheumatic fever (ARF) is exceedingly rare. Here, we report the results of the first prospective epidemiologic survey to diagnose and characterize ARF at the community level in Africa. Methods and Results: A cross‐sectional study was conducted in Lira, Uganda, to inform the design of a broader epidemiologic survey. Key messages were distributed in the community, and children aged 3 to 17 years were included if they had either (1) fever and joint pain, (2) suspicion of carditis, or (3) suspicion of chorea, with ARF diagnoses made by the 2015 Jones Criteria. Over 6 months, 201 children met criteria for participation, with a median age of 11 years (interquartile range, 6.5) and 103 (51%) female. At final diagnosis, 51 children (25%) had definite ARF, 11 (6%) had possible ARF, 2 (1%) had rheumatic heart disease without evidence of ARF, 78 (39%) had a known alternative diagnosis (10 influenza, 62 malaria, 2 sickle cell crises, 2 typhoid fever, 2 congenital heart disease), and 59 (30%) had an unknown alternative diagnosis. Conclusions: ARF persists within rheumatic heart disease–endemic communities in Africa, despite the low rates reported in the literature. Early data collection has enabled refinement of our study design to best capture the incidence of ARF and to answer important questions on community sensitization, healthcare worker and teacher education, and simplified diagnostics for low‐resource areas. This study also generated data to support further exploration of the relationship between malaria and ARF diagnosis in rheumatic heart disease/malaria‐endemic countries

Physiological and autonomic stress responses after prolonged sleep restriction and subsequent recovery sleep in healthy young men

Purpose Sleep restriction is increasingly common and associated with the development of health problems. We investigated how the neuroendocrine stress systems respond to prolonged sleep restriction and subsequent recovery sleep in healthy young men. Methods After two baseline (BL) nights of 8 h time in bed (TIB), TIB was restricted to 4 h per night for five nights (sleep restriction, SR, n = 15), followed by three recovery nights (REC) of 8 h TIB, representing a busy workweek and a recovery weekend. The control group (n = 8) had 8 h TIB throughout the experiment. A variety of autonomic cardiovascular parameters, together with salivary neuropeptide Y (NPY) and cortisol levels, were assessed. Results In the control group, none of the parameters changed. In the experimental group, heart rate increased from 60 +/- 1.8 beats per minute (bpm) at BL, to 63 +/- 1.1 bpm after SR and further to 65 +/- 1.8 bpm after REC. In addition, whole day low-frequency to-high frequency (LF/HF) power ratio of heart rate variability increased from 4.6 +/- 0.4 at BL to 6.0 +/- 0.6 after SR. Other parameters, including salivary NPY and cortisol levels, remained unaffected. Conclusions Increased heart rate and LF/HF power ratio are early signs of an increased sympathetic activity after prolonged sleep restriction. To reliably interpret the clinical significance of these early signs of physiological stress, a follow-up study would be needed to evaluate if the stress responses escalate and lead to more unfavourable reactions, such as elevated blood pressure and a subsequent elevated risk for cardiovascular health problems.Peer reviewe

B7-H1 Blockade Increases Survival of Dysfunctional CD8+ T Cells and Confers Protection against Leishmania donovani Infections

Experimental visceral leishmaniasis (VL) represents an exquisite model to study CD8+ T cell responses in a context of chronic inflammation and antigen persistence, since it is characterized by chronic infection in the spleen and CD8+ T cells are required for the development of protective immunity. However, antigen-specific CD8+ T cell responses in VL have so far not been studied, due to the absence of any defined Leishmania-specific CD8+ T cell epitopes. In this study, transgenic Leishmania donovani parasites expressing ovalbumin were used to characterize the development, function, and fate of Leishmania-specific CD8+ T cell responses. Here we show that L. donovani parasites evade CD8+ T cell responses by limiting their expansion and inducing functional exhaustion and cell death. Dysfunctional CD8+ T cells could be partially rescued by in vivo B7-H1 blockade, which increased CD8+ T cell survival but failed to restore cytokine production. Nevertheless, B7-H1 blockade significantly reduced the splenic parasite burden. These findings could be exploited for the design of new strategies for immunotherapeutic interventions against VL

Micropropagation and conservation of selected endangered anticancer medicinal plants from the Western Ghats of India

Globally, cancer is a constant battle which severely affects the human population. The major limitations of the anticancer drugs are the deleterious side effects on the quality of life. Plants play a vital role in curing many diseases with minimal or no side effects. Phytocompounds derived from various medicinal plants serve as the best source of drugs to treat cancer. The global demand for phytomedicines is mostly reached by the medicinal herbs from the tropical nations of the world even though many plant species are threatened with extinction. India is one of the mega diverse countries of the world due to its ecological habitats, latitudinal variation, and diverse climatic range. Western Ghats of India is one of the most important depositories of endemic herbs. It is found along the stretch of south western part of India and constitutes rain forest with more than 4000 diverse medicinal plant species. In recent times, many of these therapeutically valued herbs have become endangered and are being included under the red-listed plant category in this region. Due to a sharp rise in the demand for plant-based products, this rich collection is diminishing at an alarming rate that eventually triggered dangerous to biodiversity. Thus, conservation of the endangered medicinal plants has become a matter of importance. The conservation by using only in situ approaches may not be sufficient enough to safeguard such a huge bio-resource of endangered medicinal plants. Hence, the use of biotechnological methods would be vital to complement the ex vitro protection programs and help to reestablish endangered plant species. In this backdrop, the key tools of biotechnology that could assist plant conservation were developed in terms of in vitro regeneration, seed banking, DNA storage, pollen storage, germplasm storage, gene bank (field gene banking), tissue bank, and cryopreservation. In this chapter, an attempt has been made to critically review major endangered medicinal plants that possess anticancer compounds and their conservation aspects by integrating various biotechnological tool

Adoption of Research Recommendations by Rice Farmers : A Case Study on Bangkok Plain

Farm survey and field experiments on farmers' fields and at Suphanburi Rice Experiment Station were conducted from April 1993 to January 1994 to gather information on crop management practices followed by farmers and to evaluate applied N response. Field experiments consisted of three treatments : i) control with no N but recommended P fertilizer applied ; ii) fertilizer dosage by the farmer oraverage dosage used by farmers in the survey ; and ni) fertilizer dosage recommended by the Department of Agriculture (DOA). Thirty-nine % of farmers used herbicide and pesticide dosages in excess of the DOA recommended dosage. 18 types of pesticides of class Moderate to Extremely Hazardous not recommended by DOA were used by farmers. Only 18 % of farmers were aware of the recommended herbicide and pesticide dosages. Not all farmers (only 65 %) were aware of proper handling and storage procedures for herbicides and pesticides. Only 11 % of farmers were aware of fertilizer recommendations. 84 % used fertilizer dosage higherthan the DOA recommended dosage. On average, 34 kg of N ha-1 and 5 kg of P ha-1 were used in excess ofthe DOA recommended dosage in one season. The excess dosage did not produce grain and straw yields higher than the recommended dosage on both farmers' fields and at the experimental station. Furthermore, N response (kg grain per kg N) was 60 % lower than at DOA recommended dosage. Farmers trusted results from their own field experiment more than results from the experimental station. They were willing to adopt DOA recommendations during the next growing season. However, a follow-up survey conducted in the next season showed that farmers had not adopted the DOA recommendations. Reason given was that they are used to applying high doses and that it gives high yields

Water Productivity of Irrigated Rice under Transplanting, Wet Seeding and Dry Seeding Methods of Cultivation

Water productivity (WP) of irrigated lowland rice was determined during the 1994 dry (January to May) and wet (August to December) seasons on a heavy clay acid sulphate soil. Treatments consisted of three cultivation methods : transplanted rice, pregerminated seeds broadcasted on puddled soil (wet seeding) and dry seeds broadcasted on unpuddled soil (dry seeding). In wet and dry seeded plots, continuous standing water condition was initiated 17 days after sowing. Total water requirement for rice production was highest in transplanted plots (755 mm in wet season and 1154 mm in dry season) and was lowest in dry seeded plots (505 mm in wet season and 1040 mm in dry season). Dry seeding required no water for land preparation but transplanting and wet seeding methods required 18 - 20 % of total water requirement in dry season and 27 - 29 % in wet season. Total percolation was maximum (99 mm in wet season and 215 mm in dry season) in dry seeding method and was minimum (62 mm in wet season and 94 mm in dry season) in transplanting method. In dry and wet seeding methods, daily percolation gradually decreased with the age of the crop. Total seepage loss did not show any significant difference between the cultivation methods in the two seasons. Grain yield was not affected by the three cultivation methods in both seasons. Water productivity (the ratio between grain yield and total amount of water used in production) was 3.5 - 4.1 kg ha-1 mm-1, 3.8 - 4.4 kg ha-1 mm-1 and 4.1 - 5.5 kg ha-1 mm-1 in transplanted, wet seeded and dry seeded rice, respectively. Labour requirement for land preparation and sowing was maximum in transplanted (219 - 226 man-hours ha-1) followed by wet (104 -112 man-hours ha-1) and dry seeded (94 - 99 man-hours ha-1) methods. However, in wet season extra labour (77 man-hours ha-1) was required for weeding after crop establishment in dry and wet seeding methods. Crop maturity was 20 days earlier in wet and dry seeding methods compared to transplanting. Dry seeding was considered the best rice cultivation method on heavy clay soils

Effect of friction on the performance of inertial slider

Inertial sliders are friction based drives used to position with a resolution of a fewhundred of nanometers to over a range of fewmillimeters. The compactness and simple construction enabled it to be used as a coarse positioner in various Scanning Probe Microscopes (SPM). Even heavy masses has been thought off earlier to use the inertial slider to position precisely, lack of understanding in the dynamical friction behaviour has been the main reason why the inertial sliders potential has not been explored fully in any practical device. In this paper, we have studied the effect of different operating parameters on the step size of the slider. The inertial mass is kept on three sapphire balls, which are attached to shear piezoelectric material. The behaviour of inertial mass was studied for different input waveforms and different surface conditions that come in contact with the sapphire balls. It was observed that under lubricated conditions the step size was reduced