Relationships between herbaceous diversity and biomass in two habitats in arid Mediterranean rangeland

Plant diversity patterns vary across the landscape. This study was conducted to answer the question: What is the pattern of species diversity (α and β) along an abstract productivity/cover gradient at two topographical positions (Wadi (a depression with overland flow) and hilltop) of a Mediterranean herbaceous plant community in Jordan? Results indicated that the less productive hilltop localities exhibited higher species richness than the more productive Wadi localities. Species richness exhibited a unimodal relationship with aboveground biomass within Wadis whereas a positive linear relationship was revealed for hilltops. Within Wadis, abundant species did not show a significant relationship with productivity while common and rare species showed a unimodal relationship. Within hilltops, abundant, common, and rare species showed a linear relationship with biomass. β-diversity, measured as species dissimilarity, showed significant negative relationship to biomass within hilltops, whereas a positive relationship was observed within Wadis. Wilson-Shmida index (βT) had a unimodal function with increased differences in productivity whereas Morisita-Horn index (Cmh) showed a reverse unimodal relationship. Examination of the species richness-biomass relationship among species groups (abundant, common, and rare) suggested that abundant species maybe more important on low productivity sites whereas common and rare species maybe more important on high productivity sites

Presentation and outcome of twenty patients with synchronous stage IV rectal carcinoma

Purpose: Palliative treatment techniques for advanced stage rectal cancer should be designed according to the patients’ major symptoms. Combined chemo-radiation therapy is effective choice for symptomatic patients with good performance status. In this study, we reviewed our patients' stage IV rectal carcinoma in regard to most common presentation, outcome and possible prognostic features.Methods Medical chart of twenty patients who were diagnosed with stage IV rectal carcinoma, were reviewed based on the hospital database information, which included images, radiotherapy charts, and their follow up notes.  Results: All patients were young with age less than 40 years. Bleeding per rectum, pain, and symptoms of obstruction were the most common presentation. Seven patients had solitary lesion and 13 patients had multiple lesions. Eleven patients with multiple metastases were treated with palliative chemotherapy and radiotherapy. Patients who had solitary metastases to liver had a median survival time of 49 months versus 13.5 months for other patients (p = 0.001). Conclusion: Patients who presented with solitary liver metastases could be treated with a course of neoadjuvant chemo-radiotherapy similar to the curative one.-----------------------------------Cite this article as: Aboziada MA, Attia AM, Alhamad AA. Presentation and outcome of twenty patients with synchronous stage IV rectal carcinoma. Int J Cancer Ther Oncol 2014; 2(3):020313. DOI:10.14319/ijcto.0203.1

Analysis and Design Methodology of a Novel Integration Topology of Storageless Off-Grid PV Systems

In this manuscript, a novel topology is proposed to integrate on-grid and off-grid PV systems supplying the same load premises. The load side is investigated and analyzed, and critical and non-critical loads are separated in terms of power supply. Critical and seasonal loads usually place stress on the grid’s point of common coupling (PCC). In the proposed topology, they are supplied by a novel topology for an off-grid solar pump PV system that lacks energy storage integration. The lack of energy storage batteries requires a novel design and sizing scheme for the off-grid PV system, and a methodology is proposed in this manuscript. The on-grid PV system is conventionally designed and coupled with the storage-less off-grid PV system to maintain load supply. The proposed methodology minimizes the ratings of the PCC and hence relieves stress on congested grids with renewable energy penetration, especially in condensed urban areas. The proposed structure enables the operation of microgrids with high penetration levels of renewable energy resources and minimizes dependance on storage batteries for off-grid systems. A case study is presented and thoroughly analyzed with the proposed methodology. The outcomes of the design process are evaluated economically and were found to be feasible, as is detailed and supported with simulation results

The impact of direct‐acting antiviral agents on liver and kidney transplant costs and outcomes

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146297/1/ajt14895_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146297/2/ajt14895.pd

Concurrent use of nivolumab and radiotherapy for patients with metastatic non‑small cell lung cancer and renal cell carcinoma with oligometastatic disease progression on nivolumab

Checkpoint inhibitors (CPIs), such as nivolumab, have transformed the treatment paradigm for patients with metastatic non‑small cell lung cancer (mNSCLC) and metastatic renal cell carcinoma (mRCC). The combination of CPIs and radiotherapy (RT) constitutes a multimodal treatment approach that may work synergistically and facilitate augmented systemic responses. The aim of the present retrospective study was to assess the efficacy and safety of continuation of nivolumab treatment with the addition of RT in patients with mNSCLC and mRCC who develop oligometastatic disease progression on single‑agent nivolumab. All patients with mNSCLC and mRCC who received nivolumab at the Department of Oncology, Prince Sultan Military Medical City (Riyadh, Saudi Arabia) between November 2016 and April 2018 were identified. The records of patients who developed oligometastatic disease progression during nivolumab treatment and were subsequently treated with RT, with nivolumab continued beyond disease progression, were retrospectively reviewed. Details of RT, clinical outcomes and toxicity data were collected. Of the 96 patients who received nivolumab, 22 received multiple courses of RT. A total of 39 sites were irradiated: Bone (n=15), lung (n=9), brain (n=8), adrenal gland (n=2), renal bed (n=2), skin (n=1), ethmoid sinus (n=1) and scalp (n=1). Partial response and complete response were noted at 25 (64%) and 3 (8%) sites, respectively. Stable disease was noted at 6 sites (15%) and disease progression was noted at 5 sites (13%). The median time on nivolumab from the date of the first fraction of RT was 4.5 months (range, 1.5‑29 months) for patients with mNSCLC and 5 months (range, 1‑38.5 months) for patients with mRCC. No patients developed grade 3‑4 toxicities. Grade 2 pneumonitis was noted in 3 patients receiving lung RT. The addition of RT appeared to initiate a response and prolong the duration of nivolumab treatment. Therefore, the combination of nivolumab and RT was found to be well tolerated, with response rates exceeding those in published studies of nivolumab monotherapy

Prescription opioid use before and after kidney transplant: Implications for posttransplant outcomes

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/1/AJT14714-sup-0001-AppendixS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/2/ajt14714_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/3/ajt14714.pd

Rare Case of Intracardiac Renal Cell Carcinoma Metastasis with Response to Nivolumab: Case Report and Literature Review

Intracardiac metastases in the absence of inferior vena cava involvement is a rare occurrence in patients with metastatic renal cell carcinoma (mRCC). There is limited evidence regarding the efficacy and safety of standard treatment modalities for mRCC patients with intracardiac metastases. Presence of intracardiac metastases is known to indicate poor prognosis and may potentially increase risk of treatment-related complications. Recent advances in RCC management have integrated nivolumab, a programmed death-1 (PD-1) receptor inhibitor, as a preferred treatment option in the second-line setting after failure of prior anti-angiogenic therapy; or in combination with ipilimumab, an anti-Cytotoxic T-lymphocyte antigen-4 antibody as first-line therapy for intermediate to poor risk patients with mRCC. The efficacy and toxicity of nivolumab in patients with mRCC and intracardiac metastases has never been reported previously. We herein present the first reported case of mRCC with intracardiac metastasis and a resultant excellent response to nivolumab treatment and discuss the imaging techniques and treatment options for this rare presentation