Functional decline after surgery in older patients with head and neck cancer

Introduction: In addition to classical endpoints such as survival and complication rates, other outcomes such as quality of life and functional status are increasingly recognized as important endpoints, especially for elderly patients. However, little is known about the long-term effect of surgery with regard to these other outcomes. Our aim is to investigate the functional status and self-reported health status of patients > 70 years one year after surgery for head and neck cancer. Methods: We present one-year follow-up data of patients > 70 year who underwent surgery for HNC. During an interview by telephone, functional status was evaluated by using the Katz-15 Index of Independence questionnaire including six items covering basic Activities of Daily Living (ADL) and nine items covering Instrumental Activities of Daily Living (IADL). Measurements were compared with those obtained preoperatively. Results: In total, 126 patients were included and eventually we collected follow-up data of 68 patients. There was a statistically significant decrease in functional status on the total Katz-15 and on the IADL questionnaire scores one year after surgery (mean 1.34 versus 2.42, p -value 0.00 and mean 1.21 versus 1.94, p- value 0.00). There was no significant change concerning ADL dependence ( p -value 0.18) and cognitive status ( p -value 0.11). The self-reported health status improved postoperatively, although not statistically significantly so (mean 67.36 versus 71.25, p -value 0.12). Conclusion: Approximately-one year after surgery for HNC, there is a significant decline in functional status indicating a higher level of dependency.Pathophysiology, epidemiology and therapy of agein

Guided internet-based transdiagnostic individually tailored Cognitive Behavioral Therapy for symptoms of depression and/or anxiety in college students: A randomized controlled trial

Pathways through Adolescenc

Topological A-Type Models with Flux

We study deformations of the A-model in the presence of fluxes, by which we mean rank-three tensors with antisymmetrized upper/lower indices, using the AKSZ construction. Generically these are topological membrane models, and we show that the fluxes are related to deformations of the Courant bracket which generalize the twist by a closed 3-from $H$, in the sense that satisfying the AKSZ master equation implies the integrability conditions for an almost generalized complex structure with respect to the deformed Courant bracket. In addition, the master equation imposes conditions on the fluxes that generalize $dH=0$. The membrane model can be defined on a large class of $U(m)$- and $U(m) \times U(m)$-structure manifolds, including geometries inspired by $(1,1)$ supersymmetric $\sigma$-models with additional supersymmetries due to almost complex (but not necessarily complex) structures in the target space. Furthermore, we show that the model can be defined on three particular half-flat manifolds related to the Iwasawa manifold. When only $H$-flux is turned on it is possible to obtain a topological string model, which we do for the case of a Calabi-Yau with a closed 3-form turned on. The simplest deformation from the A-model is due to the $(2,0)+ (0,2)$ component of a non-trivial $b$-field. The model is generically no longer evaluated on holomorphic maps and defines new topological invariants. Deformations due to $H$-flux can be more radical, completely preventing auxiliary fields from being integrated out.Comment: 30 pages. v2: Improved Version. References added. v3: Minor changes, published in JHE

Serum peptide signatures for pancreatic cancer based on mass spectrometry: a comparison to CA19-9 levels and routine imaging techniques

Cellular mechanisms in basic and clinical gastroenterology and hepatolog

A Theory of Rational Attitude Polarization

Numerous experiments have demonstrated the possibility of attitude polarization. For instance, Lord, Ross & Lepper (1979) partitioned subjects into two groups, according to whether or not they believed the death penalty had a deterrent effect, and presented them with a set of studies on the issue. Believers and skeptics both become more convinced of their initial views; that is, the population polarized. Many scholars have concluded that attitude polarization shows that people process information in a biased manner. We argue that not only is attitude polarization consistent with an unbiased evaluation of evidence, it is to be expected in many circumstances where it arises. At the same time, some experiments do not find polarization, under the conditions in which our theory predicts the absence of polarization

Comprehensive multiplexed immune profiling of the ductal carcinoma in situ immune microenvironment regarding subsequent ipsilateral invasive breast cancer risk

Background: Ductal carcinoma in situ (DCIS) is treated to prevent subsequent ipsilateral invasive breast cancer (iIBC). However, many DCIS lesions will never become invasive. To prevent overtreatment, we need to distinguish harmless from potentially hazardous DCIS. We investigated whether the immune microenvironment (IME) in DCIS correlates with transition to iIBC.Methods: Patients were derived from a Dutch population-based cohort of 10,090 women with pure DCIS with a median follow-up time of 12 years. Density, composition and proximity to the closest DCIS cell of CD20+ B-cells, CD3+CD8+ T-cells, CD3+CD8- T-cells, CD3+FOXP3+ regulatory T-cells, CD68+ cells, and CD8+Ki67+ T-cells was assessed with multiplex immunofluorescence (mIF) with digital whole-slide analysis and compared between primary DCIS lesions of 77 women with subsequent iIBC (cases) and 64 without (controls).Results: Higher stromal density of analysed immune cell subsets was significantly associated with higher grade, ER negativity, HER-2 positivity, Ki67 ≥ 14%, periductal fibrosis and comedonecrosis (P Conclusion: IME features analysed by mIF in 141 patients from a well-annotated cohort of pure DCIS with long-term follow-up are no predictors of subsequent iIBC, but do correlate with other factors (grade, ER, HER2 status, Ki-67) known to be associated with invasive recurrences.</p

Multiethnic meta-analysis identifies ancestry-specific and cross-ancestry loci for pulmonary function

Nearly 100 loci have been identified for pulmonary function, almost exclusively in studies of European ancestry populations. We extend previous research by meta-analyzing genome-wide association studies of 1000 Genomes imputed variants in relation to pulmonary function in a multiethnic population of 90,715 individuals of European (N = 60,552), African (N = 8429), Asian (N = 9959), and Hispanic/Latino (N = 11,775) ethnicities. We identify over 50 additional loci at genome-wide significance in ancestry-specific or multiethnic meta-analyses. Using recent fine-mapping methods incorporating functional annotation, gene expression, and differences in linkage disequilibrium between ethnicities, we further shed light on potential causal variants and genes at known and newly identified loci. Several of the novel genes encode proteins with predicted or established drug targets, including KCNK2 and CDK12. Our study highlights the utility of multiethnic and integrative genomics approaches to extend existing knowledge of the genetics of l