Assessing the prognostic value of tumor-infiltrating CD57+ cells in advanced stage head and neck cancer using QuPath digital image analysis

This study aimed to assess the prognostic value of intratumoral CD57+ cells in head and neck squamous cell carcinoma (HNSCC) and to examine the reproducibility of these analyses using QuPath. Pretreatment biopsies of 159 patients with HPV-negative, stage III/IV HNSCC treated with chemoradiotherapy were immunohistochemically stained for CD57. The number of CD57+ cells per mm2 tumor epithelium was quantified by two independent observers and by QuPath, software for digital pathology image analysis. Concordance between the observers and QuPath was assessed by intraclass correlation coefficients (ICC). The correlation between CD57 and clinicopathological characteristics was assessed; associations with clinical outcome were estimated using Cox proportional hazard analysis and visualized using Kaplan-Meier curves. The patient cohort had a 3-year OS of 65.8% with a median follow-up of 54 months. The number of CD57+ cells/mm2 tumor tissue did not correlate to OS, DFS, or LRC. N stage predicted prognosis (OS: HR 0.43, p = 0.008; DFS: HR 0.41, p = 0.003; LRC: HR 0.24, p = 0.007), as did WHO performance state (OS: HR 0.48, p = 0.028; LRC: 0.33, p = 0.039). Quantification by QuPath showed moderate to good concordance with two human observers (ICCs 0.836, CI 0.805–0.863, and 0.741, CI 0.692–0.783, respectively). In conclusion, the presence of CD57+ TILs did not correlate to prognosis in advanced stage, HPV-negative HNSCC patients treated with chemoradiotherapy. Substantial concordance between human observers and QuPath was found, confirming a promising future role for digital, algorithm driven image analysis

The effects of once- versus twice-weekly sessions on psychotherapy outcomes in depressed patients

Background It is unclear what session frequency is most effective in cognitive-behavioural therapy (CBT) and interpersonal psychotherapy (IPT) for depression.Aims Compare the effects of once weekly and twice weekly sessions of CBT and IPT for depression.Method We conducted a multicentre randomised trial from November 2014 through December 2017. We recruited 200 adults with depression across nine specialised mental health centres in the Netherlands. This study used a 2 × 2 factorial design, randomising patients to once or twice weekly sessions of CBT or IPT over 16-24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II at baseline, before session 1, and 2 weeks, 1, 2, 3, 4, 5 and 6 months after start of the intervention. Intention-to-treat analyses were conducted.Results Compared with patients who received weekly sessions, patients who received twice weekly sessions showed a statistically significant decrease in depressive symptoms (estimated mean difference between weekly and twice weekly sessions at month 6: 3.85 points, difference in effect size d = 0.55), lower attrition rates (n = 16 compared with n = 32) and an increased rate of response (hazard ratio 1.48, 95% CI 1.00-2.18).Conclusions In clinical practice settings, delivery of twice weekly sessions of CBT and IPT for depression is a way to improve depression treatment outcomes

Randomized controlled trial on the effect of 1-hour infusion of vincristine versus push injection on neuropathy in children with cancer (final analysis)

Introduction: Vincristine is an integral component of treatment for children with cancer. Its main dose-limiting side effect is vincristine-induced peripheral neuropathy (VIPN). The VINCA trial was a randomized controlled trial that explored the effect of 1-hour infusion compared with push injection of vincristine on the development of VIPN in children with cancer. The short-term outcomes (median follow-up 9 months) showed that there was no difference in VIPN between the randomization groups. However, 1-hour infusion was less toxic in children who also received azoles. We now report the results of the final analyses (median follow-up 20 months), which includes treatment outcome as a secondary objective (follow-up 3 years). Methods: VIPN was measured 1–7 times per participant using the Common Terminology Criteria for Adverse Events (CTCAE) and the pediatric-modified total neuropathy score. Poisson mixed model and logistic generalized estimating equation analysis for repeated measures were performed.Results: Forty-five participants per randomization group were included. There was no significant effect of 1-hour infusion compared with push injection on VIPN. In participants receiving concurrent azoles, the total CTCAE score was significantly lower in the one-hour group (rate ratio 0.52, 95% confidence interval 0.33–0.80, p = 0.003). Four patients in the one-hour group and one patient in the push group relapsed. Two patients in the one-hour group died. Conclusion:1-hour infusion of vincristine is not protective against VIPN. However, in patients receiving concurrent azoles, 1-hour infusion may be less toxic. The difference in treatment outcome is most likely the result of differences in risk profile.</p

Thrombolysis with tissue plasminogen activator in acute myocardial infarction: no additional benefit from immediate percutaneous coronary angioplasty

A randomised trial of 367 patients with acute myocardial infarction was performed to determine whether an invasive strategy combining thrombolysis with recombinant tissue-type plasminogen activator (rTPA), heparin, and acetylsalicylic acid, and immediate percutaneous transluminal coronary angioplasty (PTCA) would be superior to a noninvasive strategy with the same medical treatment but without immediate angiography and PTCA. Intravenous infusion of 100 mg rTPA was started within 5 h after onset of symptoms (median 156 min). Angiography was performed 6-165 min later in 180 out of 183 patients allocated to the invasive strategy; 184 patients were allocated to the non-invasive strategy. Immediate PTCA reduced the percentage stenosis of the infarc

Meta-analysis of 49 549 individuals imputed with the 1000 Genomes Project reveals an exonic damaging variant in ANGPTL4 determining fasting TG levels

Background So far, more than 170 loci have been associated with circulating lipid levels through genomewide association studies (GWAS). These associations are largely driven by common variants, their function is often not known, and many are likely to be markers for the causal variants. In this study we aimed to identify more new rare and low-frequency functional variants associated with circulating lipid levels. Methods We used the 1000 Genomes Project as a reference panel for the imputations of GWAS data from ~60 000 individuals in the discovery stage and ~90 000 samples in the replication stage. Results Our study resu

Report on the Polycystididae (Rhabdocoela, Kalyptorhynchia) from Australia, with the description of twelve new species and six new genera

Twelve new species of Polycystididae Graff, 1905 are described from the Australian east coast. Nine of them could not be placed in any of the existing genera, and therefore six new genera are erected. Alchoides n. gen. differs from all other polycystidid genera by the presence of a bundle of glands that opens into the distal part of the male atrium (accessory vesicle type V). Two species are included in the genus, A. alchoides n. sp. and A. dittmannae n. sp., which differ from each other in the shape of the stylet. Ametochus gehrkei n. gen n. sp. can be distinguished from other polycystidids by the presence of a prostate vesicle type III associated with a prostate stylet type III, combined with the presence of an accessory stylet type III, while a prostate stylet type II is lacking. Typical for Arrawarria inexpectata n. gen n. sp. is the combined presence of an armed cirrus with a prostate vesicle type II connected to a prostate stylet type II. Two species are assigned to the new genus Duplexostylus n. gen.: D. rowei n. sp. and D. winsori n. sp. These two species have two unique features: a prostate vesicle type IV directly connected to a prostate stylet type III and an asymmetrical septum that surrounds the proximal part of the male atrium. They can be distinguished from each other by differences in the detailed construction of their stylets. Two new species are placed in the new genus Stradorhynchus n. gen.: S. caecus n. sp. and S. terminalis n. sp. They have unpaired gonads and a prostate vesicle type IV connected to a prostate stylet type IV, which combination of characters makes them unique within the Polycystididae. The two species differ from each other in the shape and size of the stylet. Triaustrorhynchus armatus n. gen., n. sp. is the first species of the Polycystididae to have three types of stylet in the male atrium: a prostate stylet type II, a prostate stylet type III and an accessory stylet type III. Three new species could be placed in existing genera: Cincturorhynchus monaculeus n. sp., Paraustrorhynchus caligatus n. sp. and Polycystis australis n. sp. All three differ from their congeners in the form and dimensions of their stylets. All newly described species are discussed, giving their similarities and differences with resembling species. Austrorhynchus hawaiiensis Karling, 1977 is reported for the first time in Australia, and the Australian population is compared with populations from other regions. The presence of Gyratrix hermaphroditus Ehrenberg, 1831, one new species of Paulodora Marcus, 1948 and a new genus of Typhlopolycystidinae Evdonin, 1977 is mentioned