The Impact of Sociocultural Factors on the Development of Entrepreneurship in Thulamela Local Municipality

MCOMDepartment of Business ManagementEntrepreneurship has become the backbone of every economy in the modern era; essential for employment creation, revamping national economic performance and generating wealth. Despite it being taught in tertiary institutions and trained in vocational institutions, studies show that entrepreneurship is not achieving its full potential in contributing to economies especially in rural settings. It needs to be fostered and nurtured in sociocultural perspectives to maximise its contribution towards the economy of South Africa. The aim of the study was to establish the importance of sociocultural factors in the development of entrepreneurship in rural settings of South Africa. The study area was Thohoyandou Central Business District, Tshaulu, Tshilamba and Khubvi in Thulamela Local Municipality, Limpopo Province, South Africa. A mixed method approach was used, combining both quantitative and qualitative data collection methods to better understand the relationship between entrepreneurship development and sociocultural dimensions involved and address the research objectives. The sample for this study comprised of 100 entrepreneurial initiatives in Thulamela Local Municipality, Limpopo Province, South Africa. The researcher used a stratified purposive sampling technique, where questionnaires with both open and closed ended questions was administered as the instrument for data collection. Predictive Analytics Software (PASW) version 25, formerly known as SPSS was used for quantitative data analysis and Thematic Content Analysis was employed to analyse qualitative data. The findings indicated social impedances, lack of confidence in the services offered, gender discrimination, role models and the support system as key influencers of entrepreneurship advancement. The study also showed that culture contributes to entrepreneurship development in Thulamela Local Municipality through aspects such as resistance, traditional beliefs and looking down upon others. The study also established that entrepreneurship is considered as better than conventional day-to-day jobs because of its ability to give financial stability to individuals and consolidate and empower the community. The researcher recommended that the following factors be considered: market expansion, funding, training and skills development, community development, teaching entrepreneurship in communities and internal business adjustments.NR

Radiation Therapy for Liver Tumors: Future Directions

Radiation therapy for liver tumors has changed dramatically in the last few decades, from purely palliative to now potentially curative in the form of stereotactic body radiation therapy (SBRT). Recent progress with imaging suggests that prospective characterization of individual tumor subpopulations within these tumors may not only have prognostic value but also may allow personalized heterogeneous radiotherapy dosing. Improved on-board radiation treatment imaging strategies may lead to real-time adapted treatment tailored to the patient’s individual tumor and functional response. The future question is how best to optimize the power of SBRT both to ablate the local tumor and to potentially work with immune therapy agents to produce a systemic antitumor effect

Space-time clustering characteristics of tuberculosis in China, 2005-2011.

OBJECTIVES: China is one of the 22 tuberculosis (TB) high-burden countries in the world. As TB is a major public health problem in China, spatial analysis could be applied to detect geographic distribution of TB clusters for targeted intervention on TB epidemics. METHODS: Spatial analysis was applied for detecting TB clusters on county-based TB notification data in the national notifiable infectious disease case reporting surveillance system from 2005 to 2011. Two indicators of TB epidemic were used including new sputum smear-positive (SS+) notification rate and total TB notification rate. Global Moran's I by ArcGIS was used to assess whether TB clustering and its trend were significant. SaTScan software that used the retrospective space-time analysis and Possion probability model was utilized to identify geographic areas and time period of potential clusters with notification rates on county-level from 2005 to 2011. RESULTS: Two indicators of TB notification had presented significant spatial autocorrelation globally each year (p<0.01). Global Moran's I of total TB notification rate had positive trend as time went by (t=6.87, p<0.01). The most likely clusters of two indicators had similar spatial distribution and size in the south-central regions of China from 2006 to 2008, and the secondary clusters in two regions: northeastern China and western China. Besides, the secondary clusters of total TB notification rate had two more large clustering centers in Inner Mongolia, Gansu and Qinghai provinces and several smaller clusters in Shanxi, Henan, Hebei and Jiangsu provinces. CONCLUSION: The total TB notification cases clustered significantly in some special areas each year and the clusters trended to aggregate with time. The most-likely and secondary clusters that overlapped among two TB indicators had higher TB burden and risks of TB transmission. These were the focused geographic areas where TB control efforts should be prioritized

Comparative Outcomes of Adenosquamous Carcinoma of the Gallbladder: an Analysis of the National Cancer Database

Background A paucity of data exists regarding adenosquamous carcinoma of the gallbladder, a histology comprising under 10% of gallbladder cancer diagnoses. The aim of this study is to characterize the clinicopathological features of these tumors utilizing a population-based dataset compared with gallbladder adenocarcinoma. Methods We identified patients with gallbladder adenosquamous and adenocarcinoma from the National Cancer Database from 2004 to 2015. Patient demographics, tumor characteristics, treatment regimens, and overall survival were analyzed between the groups. Results We identified 13,158 patients: 12,455 (95%) with a diagnosis of gallbladder adenocarcinoma and 703 (5%) with adenosquamous carcinoma. Adenosquamous tumors were larger, poorly differentiated, and presented with Stage III/IV disease (75% vs 69%,p < 0.001). Overall 1-, 3-, and 5-year survival for adenosquamous and adenocarcinoma were 24%, 11%, and 9% vs 37%, 16%, and 11%, respectively (p < 0.001). Following surgical resection, adenosquamous carcinoma had more positive margins (31% vs 25%,p < 0.001), and median overall survival was 10.3 months vs 20.5 months for adenocarcinoma (p < 0.001). Overall survival at 1-, 3-, and 5-years for surgically resected adenosquamous and adenocarcinoma were 43%, 23%, and 18% versus 63%, 35%, and 25%, respectively (p < 0.001). In resected adenosquamous carcinoma, positive lymph nodes and margins were associated with worse survival, while adjuvant chemoradiation (HR 0.457, 95% CI 0.31-0.69,p < 0.001) was associated with improved survival. Conclusion Adenosquamous gallbladder cancer presented with larger tumors at advanced clinical stages when compared with adenocarcinoma. Overall survival was worse for adenosquamous tumors both overall, and following curative intent resection. Adjuvant chemoradiation was associated with improved survival in adenosquamous tumors

Impact of sarcopenia on outcomes of locally advanced esophageal cancer patients treated with neoadjuvant chemoradiation followed by surgery.

BACKGROUND: Sarcopenia is an independent predictor of clinical outcomes in multiple gastrointestinal cancers. Total psoas area (TPA), as measured on a single cross-sectional CT image at the L4 vertebral body level, has been correlated with sarcopenia. We sought to evaluate whether TPA was predictive of acute grade ≥3 toxicity, pathologic response, and overall survival in patients with locally advanced esophageal cancer receiving tri-modality therapy. METHODS: An institutional database of esophageal cancer patients treated with neoadjuvant chemoradiation followed by surgery was queried. Of 77 patients treated from 2008 to 2012 with intensity modulated radiation therapy (IMRT) and image guided radiation therapy (IGRT), 56 patients were eligible based on having CT imaging that included the L4 vertebral body. The L4 vertebra was identified on axial CT and the psoas muscle was manually contoured bilaterally to determine the skeletal muscle index. Sarcopenia was defined by the presence of the psoas area less than the median of the cohort. Acute toxicity was defined as within 3 months of radiotherapy based on Common Terminology Criteria for Adverse Events. ROC curve, logistic regression, and Kaplan Meier estimates were used when appropriate. RESULTS: Sarcopenia was associated with increased acute grade ≥3 toxicity from chemoradiation by ROC analysis using a cut off of 841.5 mm CONCLUSIONS: In our cohort of patients, sarcopenia was associated with a significant increase in acute grade ≥3 toxicity with chemoradiation, suggesting a potential role for neoadjuvant patient selection strategies. There was no difference in pathologic response or overall survival

The Colorectal Cancer Tumor Microenvironment and Its Impact on Liver and Lung Metastasis

Colorectal cancer (CRC) is the third most common malignancy and the second most common cause of cancer-related mortality worldwide. A total of 20% of CRC patients present with distant metastases, most frequently to the liver and lung. In the primary tumor, as well as at each metastatic site, the cellular components of the tumor microenvironment (TME) contribute to tumor engraftment and metastasis. These include immune cells (macrophages, neutrophils, T lymphocytes, and dendritic cells) and stromal cells (cancer-associated fibroblasts and endothelial cells). In this review, we highlight how the TME influences tumor progression and invasion at the primary site and its function in fostering metastatic niches in the liver and lungs. We also discuss emerging clinical strategies to target the CRC TME