Advanced head and neck cancer: Long-term results of chemo-radiotherapy, complications and induction of second malignancies

Background: Chemo-radiotherapy is superior to radiotherapy alone in the treatment of advanced, inoperable head and neck cancer. The long-term treatment results, the induction of second malignant tumors, and other long-term toxicities are not well defined. Patients and Methods: 100 consecutive patients with advanced head and neck cancer who were treated at our center were studied. Treatment results, survival, the occurrence of late complications, and second malignant tumors (SMT) were investigated. 78 patients were treated with a protocol combining cisplatinum, 5-fluorouracil, folinic acid and hyper-fractionated irradiation. 22 patients were treated with other chemo-radiotherapy protocols. The relative risk of developing an SMT was compared with that within the normal population. Results: The cumulative total probability of survival was 51.1% at 2 years and 38.7% at 4 years. The probability of relapse-free survival was 39.9% at 2 years and 36.7% at 4 years. A total of 7 patients developed SMT (4 cases of lung cancer, 2 colon cancers, 1 skin cancer). After 6 years, a cumulative risk of SMT of 8.7% was observed. The relative risk of developing an SMT was significantly increased (4.45-fold in males) compared with a normal population. 13 of 38 evaluable patients (34.2%) had severe late complications like fibrosis of soft tissues, nerve lesions, or were dependent on tracheal cannulas. Conclusions: The treatment results and long-term prognoses in our population of unselected high-risk patients are unsatisfactory, but comparable to those from multicenter studies. About 35% of patients become long-term (> 4 years) survivors. SMT generally occur early, have a poor prognosis and, most likely, are not treatment-related. Approximately 30% of long-term survivors have severe, often incapacitating late effects. The treatment and - if possible - prevention of these late effects is important for the quality of life of patients who survived advanced head and neck cancer

Spontaneous bleeding in a patient with malignant lymphoma: A case of acquired hemophilia

Background: Acquired hemophilia is a rare condition which can be associated with lymphoproliferative disease. Case Report: Eleven yea rs after the diagnosis of immunocytoma had been made, a 72-year-old man developed a high-titer factor VIII inhibitor. At this time, the lymphoma was without significant progress and there was no paraprotein in the serum. Partial thromboplastin time (PTT) was 83 a, factor-VIII clotting activity was <1%, and inhibitor level was 50.4 Bethesda units. The patient presented with spontaneous hematomas in the skin and musculature of the extremities. Following combination chemotherapy with cyclophosphamide, vincristine and prednisolone (COP), there was a prompt disappearance of the inhibitor and normalization of coagulation; however, the patient developed serious infectious complications. When the inhibitor recurred he was treated with low-dose cyclophosphamide and prednisolone. This time there was a more delayed response, but the inhibitor disappeared again completely. Two months after cessation of therapy, there was again relapse. Conclusion: Causal relationship between lymphoma and acquired hemophilia remains speculative. At least in some cases of factor VIII inhibitors associated with malignant disease, immunosuppressive therapy may be sufficient to suppress the inhibitor

Trajectory Model for Identification of Oil Spill Around the Coast of Pari Island, Seribu Islands, North Jakarta

Oil spills at sea are common in the shipping lanes of the ship as well as the locations of offshore oil drilling. Unfortunately, in every occurrence of the oil spill, we only see the effects after the occurrence, without knowing the original source. Indonesian Numerical Coastal Environmental Assessment (IndoNACE) is research collaboration between Indonesian and Germany by applying satellite data, numerical modeling, and field observations to make an assessment on environmental consequences to oil spills at sea. One of the locations of these research activities is Pari Island, Seribu Islands, North Jakarta. Simulation of hydrodynamic models around Pulau Pari with Hamburg Shelf Ocean Model (HAMSOM) was performed using tides, surface winds, and density difference of seawater as input. Afterwards, by utilizing results of the hydrodynamic model, the spreading of oil spills as well as the origin of the oil spills were estimated using forward and backward trajectory models, respectively. In the case study of Pari Island, there is a presence of thin film of oil in 5 November 2015 that disappears after one day. We suggest that the origin of oil spills were found on the beach Pari Island is expected from the east - northeast of Thousand Islands and is likely from the subsea pipeline which runs from the north to the city of Jakarta or shipping lanes through the Indonesian archipelagic sea lanes (ALKI) I of Karimata Strait up to Java Sea and the Jakarta Bay

Sistema sulco/camalhão para irrigação e drenagem em áreas de várzea.

SISTEMA SULCO/CAMALHÃO PARA IRRIGAÇÃO E DRENAGEM EM ÁREAS DE VÁRZEA - A soja e o milho são as principais culturas produtoras de grãos utilizadas na diversificação do sistema de produção nas várzeas do Rio Grande do Sul, em rotação com o arroz irrigado. Os principais fatores limitantes, para que estas culturas sejam produtivas e rentáveis neste sistema, são a deficiente drenagem natural do solo e a ocorrência de freqüentes períodos de estiagem, acarretando alternância entre o excesso e o déficit de umidade no solo. A Embrapa Clima Temperado testou e validou a técnica sulco/camalhão em áreas sistematizadas com e sem declive, para estes cultivos, com resultados bastante promissores. O sistema consiste na estruturação da lavoura para a irrigação por sulcos, obtendo-se, ao mesmo tempo, grande benefício em drenagem, com o cultivo sobre os camalhões formados entre os sulcos. Esta técnica, como sistema complementar de drenagem superficial do solo, mostrou-se muito eficiente mesmo nos cultivos em áreas sistematizadas sem declive, onde não existe um gradiente para escoamento superficial da água. O principal requisito para a irrigação por sulcos é que o terreno tenha uma declividade constante e uniforme, requerendo geralmente a sistematização do terreno. Para irrigações mais uniformes e eficientes, a declividade deve variar de 0,10% a 0,50%, sendo que valores intermediários entre 0,15% e 0,30% são os mais indicadosbitstream/item/31294/1/comunicado-165.pd

Discontinuities in the late 1960's in different atmospheric data products

An analysis of the onset and spatial extent of discontinuities in the late 1960's in different atmospheric data products is performed. Discontinuities are found in both the NCEP/NCAR and ERA-40 reanalyses in various surface variables including sea level pressure (SLP) in both data sets over Africa, in the NCEP/NCAR reanalysis also over Asia and in the ERA-40 reanalysis also over South America, and precipitation in the NCEP/NCAR reanalysis over North Africa. Discontinuities are also found in 2 m air temperature in both reanalyses. The discontinuities in SLP extend into the lower troposphere. The main cause of these discontinuities appears to be missing or limited synoptic data prior to the late 1960's

Conserved presence of G-quadruplex forming sequences in the Long Terminal Repeat Promoter of Lentiviruses

G-quadruplexes (G4s) are secondary structures of nucleic acids that epigenetically regulate cellular processes. In the human immunodeficiency lentivirus 1 (HIV-1), dynamic G4s are located in the unique viral LTR promoter. Folding of HIV-1 LTR G4s inhibits viral transcription; stabilization by G4 ligands intensifies this effect. Cellular proteins modulate viral transcription by inducing/unfolding LTR G4s. We here expanded our investigation on the presence of LTR G4s to all lentiviruses. G4s in the 5'-LTR U3 region were completely conserved in primate lentiviruses. A G4 was also present in a cattle-infecting lentivirus. All other non-primate lentiviruses displayed hints of less stable G4s. In primate lentiviruses, the possibility to fold into G4s was highly conserved among strains. LTR G4 sequences were very similar among phylogenetically related primate viruses, while they increasingly differed in viruses that diverged early from a common ancestor. A strong correlation between primate lentivirus LTR G4s and Sp1/NF\u3baB binding sites was found. All LTR G4s folded: their complexity was assessed by polymerase stop assay. Our data support a role of the lentiviruses 5'-LTR G4 region as control centre of viral transcription, where folding/unfolding of G4s and multiple recruitment of factors based on both sequence and structure may take place

Dynamics of Decadal Climate Variability and Implications for its Prediction

The temperature record of the last 150 years is characterized by a long-term warming trend, with strong multidecadal variability superimposed. The multidecadal variability is also seen in other (societal important) parameters such as Sahel rainfall or Atlantic hurricane activity. The existence of the multidecadal variability makes climate change detection a challenge, since Global Warming evolves on a similar timescale. The ongoing discussion about a potential anthropogenic signal in the Atlantic hurricane activity is an example. A lot of work was devoted during the last years to understand the dynamics of the multidecadal variability, and external as well as internal mechanisms were proposed. This White Paper focuses on the internal mechanisms relevant to the Atlantic Multidecadal Oscillation/Variability (AMO/V) and the Pacific Decadal Oscillation/Variability (PDO/V). Specific attention is given to the role of the Meridional Overturning Circulation (MOC) in the Atlantic. The implications for decadal predictability and prediction are discussed

A higher-resolution version of the Max Planck Institute Earth System Model (MPI-ESM1.2-HR)

The MPI‐ESM1.2 is the latest version of the Max Planck Institute Earth System Model and is the baseline for the Coupled Model Intercomparison Project Phase 6 and current seasonal and decadal climate predictions. This paper evaluates a coupled higher‐resolution version (MPI‐ESM1.2‐HR) in comparison with its lower‐resolved version (MPI‐ESM1.2‐LR). We focus on basic oceanic and atmospheric mean states and selected modes of variability, the El Niño/Southern Oscillation and the North Atlantic Oscillation. The increase in atmospheric resolution in MPI‐ESM1.2‐HR reduces the biases of upper‐level zonal wind and atmospheric jet stream position in the northern extratropics. This results in a decrease of the storm track bias over the northern North Atlantic, for both winter and summer season. The blocking frequency over the European region is improved in summer, and North Atlantic Oscillation and related storm track variations improve in winter. Stable Atlantic meridional overturning circulations are found with magnitudes of ~16 Sv for MPI‐ESM1.2‐HR and ~20 Sv for MPI‐ESM1.2‐LR at 26°N. A strong sea surface temperature bias of ~5°C along with a too zonal North Atlantic current is present in both versions. The sea surface temperature bias in the eastern tropical Atlantic is reduced by ~1°C due to higher‐resolved orography in MPI‐ESM‐HR, and the region of the cold‐tongue bias is reduced in the tropical Pacific. MPI‐ESM1.2‐HR has a well‐balanced radiation budget and its climate sensitivity is explicitly tuned to 3 K. Although the obtained reductions in long‐standing biases are modest, the improvements in atmospheric dynamics make this model well suited for prediction and impact studies

Robust skill of decadal climate predictions

There is a growing need for skilful predictions of climate up to a decade ahead. Decadal climate predictions show high skill for surface temperature, but confidence in forecasts of precipitation and atmospheric circulation is much lower. Recent advances in seasonal and annual prediction show that the signal-to-noise ratio can be too small in climate models, requiring a very large ensemble to extract the predictable signal. Here, we reassess decadal prediction skill using a much larger ensemble than previously available, and reveal significant skill for precipitation over land and atmospheric circulation, in addition to surface temperature. We further propose a more powerful approach than used previously to evaluate the benefit of initialisation with observations, improving our understanding of the sources of skill. Our results show that decadal climate is more predictable than previously thought and will aid society to prepare for, and adapt to, ongoing climate variability and change.D.M.S., A.A.S., N.J.D., L.H. and R.E. were supported by the Met Office Hadley Centre Climate Programme funded by BEIS and Defra and by the European Commission Horizon 2020 EUCP project (GA 776613). L.P.C. was supported by the Spanish MINECO HIATUS (CGL2015-70353-R) project. F.J.D.R. was supported by the H2020 EUCP (GA 776613) and the Spanish MINECO CLINSA (CGL2017-85791-R) projects. W.A. M. and H.P. were supported by the German Ministry of Education and Research (BMBF) under the project MiKlip (grant 01LP1519A). The NCAR contribution was supported by the US National Oceanic and Atmospheric Administration (NOAA) Climate Program Office under Climate Variability and Predictability Program Grant NA13OAR4310138 and by the US National Science Foundation (NSF) Collaborative Research EaSM2 Grant OCE-1243015. The NCAR contribution is also based upon work supported by NCAR, which is a major facility sponsored by the US NSF under Cooperative Agreement No. 1852977. The Community Earth System Model Decadal Prediction Large Ensemble (CESM-DPLE) was generated using computational resources provided by the US National Energy Research Scientific Computing Center, which is supported by the Office of Science of the US Department of Energy under Contract DE-AC02-05CH11231, as well as by an Accelerated Scientific Discovery grant for Cheyenne (https://doi.org/10.5065/D6RX99HX) that was awarded by NCAR’s Computational and Information System Laboratory.Peer ReviewedPostprint (published version