Aetiology of oral cancer

Oral cancer (OC) and oral squamous cell carcinoma (OSCC) are used interchangeably, as more than 95% of all OCs are OSCCs. Worldwide up to 275 000 new cases of OC are seen every year. Most of these cases are seen in developing countries such as South Africa. Up to 50% of all patients living with OC will die within five years, and this survival rate has not improved over the last few decades. Tobacco and alcohol usage account for up to 75% of all OC cases. As these causative factors can be avoided, all oral health workers should be aware of the aetiology of OC so that sound preventive advice may be given to their patients. Infections and nutrition play a lesser but still important role in the aetiology of OC. This article reviews the importance of the aetiology of OC, with the emphasis on tobacco and alcohol.http://www.sadanet.co.zaam2013ay201

Substance abuse among oral healthcare workers

The abuse of both licit and illicit substances by the general population affects at least one in ten people. Research shows that the oral healthcare worker has at least the same prevalence of substance abuse, perhaps even higher. The emergence of prescription drug abuse is one of the most worrying and dangerous aspects for the healthcare worker, due to ease of access to such drugs. According to the United Nations, prescription drug abuse is amongst the top three practices of substance abuse. We have an obligation to incorporate the evidence of substance abuse among oral healthcare professionals in our undergraduate dental curricula in order to combat this phenomenon. As the stress of daily survival in single practitioner practices increase, so will the danger of substance abuse. This may lead to impairment of the healthcare worker and ultimately loss of registration. It will take a combined effort from organised dentistry and academic institutions to establish a national strategy to ensure we address this important issue at undergraduate level and provide support at practitioner level. This paper will deal with substance abuse and the implications of impairment it holds for the oral healthcare worker.http://www.sada.co.zaam201

Teaching ultrasound in a curricular course according to certified EFSUMB standards during undergraduate medical education: a prospective study

Background: As a non-invasive and readily available diagnostic tool, ultrasound is one of the most important imaging techniques in medicine. Ultrasound is usually trained during residency preferable according to German Society of Ultrasound in Medicine (DEGUM) standards. Our curriculum calls for undergraduate training in ultrasound of medical students in their 4th year of undergraduate education. An explorative pilot study evaluated the acceptance of this teaching method, and compared it to other practical activities in medical education at Muenster University. Methods: 240 medical students in their 4th year of undergraduate medical education participated in the training and completed a pre- and post-questionnaire for self-assessment of technical knowledge, self-assurance of the procedure, and motivation in performing ultrasound using a Likert scale. Moreover, students were asked about their interest in pursuing a career in internal medicine. To compare this training to other educational activities a standardized online evaluation tool was used. A direct observation of procedural skills assessment (DOPS) for the first time applied on ultrasound aimed to independently assess the success of our teaching method. Results: There was a significant increase in technical knowledge and self-assurance (p < 0.001) of the students’ self-assessments. The clinical relevance and self-motivation of the teaching were evaluated positively. The students’ DOPS results demonstrated proficiency in the understanding of anatomic structures shown in ultrasonographic images, including terminology, machine settings, and transducer frequencies. Conclusions: Training ultrasound according to certified DEGUM standards was successful and should be offered in undergraduate medical education. The evaluation of the course affirmed the necessity, quality and clinical relevance of the course with a top ranking score of hands-on training courses within the educational activities of the Medical Faculty of Muenster.<br

Constraining models of the large scale Galactic magnetic field with WMAP5 polarization data and extragalactic Rotation Measure sources

We introduce a method to quantify the quality-of-fit between data and observables depending on the large scale Galactic magnetic field. We combine WMAP5 polarized synchrotron data and Rotation Measures of extragalactic sources in a joint analysis to obtain best fit parameters and confidence levels for GMF models common in the literature. None of the existing models provide a good fit in both the disk and halo regions, and in many instances best-fit parameters are quite different than the original values. We note that probing a very large parameter space is necessary to avoid false likelihood maxima. The thermal and relativistic electron densities are critical for determining the GMF from the observables but they are not well constrained. We show that some characteristics of the electron densities can already be constrained using our method and with future data it may be possible to carry out a self-consistent analysis in which models of the GMF and electron densities are simultaneously optimized.Comment: 27 pages, 13 figures. Accepted for publication in JCAP; arXiv version updated to include minor revision

Time course and management of key adverse events during the randomized phase III SOLAR-1 study of PI3K inhibitor alpelisib plus fulvestrant in patients with HR-positive advanced breast cancer.

Background Alpelisib (α-selective phosphatidylinositol 3-kinase inhibitor) plus fulvestrant is approved in multiple countries for men and postmenopausal women with PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer following progression on or after endocrine therapy. A detailed understanding of alpelisib's safety profile should inform adverse event (AE) management and enhance patient care. Patients and methods AEs in the phase III SOLAR-1 trial were assessed in patients with and without PIK3CA mutations. The impact of protocol-specified AE-management recommendations was evaluated, including an amendment to optimize hyperglycemia and rash management. Results Patients were randomly assigned to receive fulvestrant plus alpelisib (n = 284) or placebo (n = 287). The most common grade 3/4 AEs with alpelisib were hyperglycemia (grade 3, 32.7%; grade 4, 3.9%), rash (grade 3, 9.9%), and diarrhea (grade 3, 6.7%). Median time to onset of grade ≥3 toxicity was 15 days (hyperglycemia, based on fasting plasma glucose), 13 days (rash), and 139 days (diarrhea). Metformin alone or in combination with other antidiabetic agents was used by most patients (87.1%) with hyperglycemia. Preventive anti-rash medication resulted in lower incidence (any grade, 26.7% versus 64.1%) and severity of rash (grade 3, 11.6% versus 22.7%) versus no preventative medication. Discontinuations due to grade ≥3 AEs were lower following more-detailed AE management guidelines (7.9% versus 18.1% previously). Patients with PIK3CA mutations had a median alpelisib dose intensity of 248 mg/day. Median progression-free survival with alpelisib was 12.5 and 9.6 months for alpelisib dose intensities of ≥248 mg/day and Conclusions Hyperglycemia and rash occurred early during alpelisib treatment, while diarrhea occurred at a later time point. Early identification, prevention, and intervention, including concomitant medications and alpelisib dose modifications, resulted in less severe toxicities. Reductions in treatment discontinuations and improved progression-free survival at higher alpelisib dose intensities support the need for optimal AE management. ClinicalTrials.gov Id NCT02437318

The FMR1 CGG repeat mouse displays ubiquitin-positive intranuclear neuronal inclusions; implications for the cerebellar tremor/ataxia syndrome

Recent studies have reported that alleles in the premutation range in the FMR1 gene in males result in increased FMR1 mRNA levels and at the same time mildly reduced FMR1 protein levels. Some elderly males with premutations exhibit an unique neurodegenerative syndrome characterized by progressive intention tremor and ataxia. We describe neurohistological, biochemical and molecular studies of the brains of mice with an expanded CGG repeat and report elevated Fmr1 mRNA levels and intranuclear inclusions with ubiquitin, Hsp40 and the 20S catalytic core complex of the proteasome as constituents. An increase was observed of both the number and the size of the inclusions during the course of life, which correlates with the progressive character of the cerebellar tremor/ataxia syndrome in humans. The observations in expanded-repeat mice support a direct role of the Fmr1 gene, by either CGG expansion per se or by mRNA level, in the formation of the inclusions and suggest a correlation between the presence of intranuclear inclusions in distinct regions of the brain and the clinical features in symptomatic premutation carriers. This mouse model will facilitate the possibilities to perform studies at the molecular level from onset of symptoms until the final stage of the disease

Prevalence of impairments, disabilities, handicaps and quality of life in the general population: a review of recent literature

International audienc

Measurement of the Ratio Gamma(KL -> pi+ pi-)/Gamma(KL -> pi e nu) and Extraction of the CP Violation Parameter |eta+-|

We present a measurement of the ratio of the decay rates Gamma(KL -> pi+ pi-)/Gamma(KL -> pi e nu), denoted as Gamma(K2pi)/Gamma(Ke3). The analysis is based on data taken during a dedicated run in 1999 by the NA48 experiment at the CERN SPS. Using a sample of 47000 K2pi and five million Ke3 decays, we find Gamma(K2pi)/Gamma(Ke3) = (4.835 +- 0.022(stat) +- 0.016(syst)) x 10^-3. From this we derive the branching ratio of the CP violating decay KL -> pi+ pi- and the CP violation parameter |eta+-|. Excluding the CP conserving direct photon emission component KL -> pi+ pi- gamma, we obtain the results BR(KL -> pi+ pi-) = (1.941 +- 0.019) x 10^-3 and |eta+-| = (2.223 +- 0.012) x 10^-3.Comment: 20 pages, 7 figures, accepted by Phys. Lett.

Quantifying ionospheric effects on time-domain astrophysics with the Murchison Widefield Array

© 2015 The Authors. Published by Oxford University Press on behalf of the Royal Astronomical Society. Refraction and diffraction of incoming radio waves by the ionosphere induce time variability in the angular positions, peak amplitudes and shapes of radio sources, potentially complicating the automated cross-matching and identification of transient and variable radio sources. In this work, we empirically assess the effects of the ionosphere on data taken by the Murchison Widefield Array (MWA) radio telescope. We directly examine 51 h of data observed over 10 nights under quiet geomagnetic conditions (global storm index Kp &lt; 2), analysing the behaviour of short-time-scale angular position and peak flux density variations of around ten thousand unresolved sources. We find that while much of the variation in angular position can be attributed to ionospheric refraction, the characteristic displacements (10-20 arcsec) at 154 MHz are small enough that search radii of 1-2 arcmin should be sufficient for crossmatching under typical conditions. By examining bulk trends in amplitude variability, we place upper limits on the modulation index associated with ionospheric scintillation of 1-3 per cent for the various nights. For sources fainter than ~1 Jy, this variation is below the image noise at typical MWA sensitivities. Our results demonstrate that the ionosphere is not a significant impediment to the goals of time-domain science with the MWA at 154 MHz

Investigation into the cause of spontaneous emulsification of a free steel droplet : validation of the chemical exchange pathway

Small Fe-based droplets have been heated to a molten phase suspended within a slag medium to replicate a partial environment within the basic oxygen furnace (BOF). The confocal scanning laser microscope (CSLM) has been used as a heating platform to interrogate the effect of impurities and their transfer across the metal/slag interface, on the emulsification of the droplet into the slag medium. The samples were then examined through X-ray computer tomography (XCT) giving the mapping of emulsion dispersion in 3D space, calculating the changing of interfacial area between the two materials, and changes of material volume due to material transfer between metal and slag. Null experiments to rule out thermal gradients being the cause of emulsification have been conducted as well as replication of the previously reported study by Assis et al.[1] which has given insights into the mechanism of emulsification. Finally chemical analysis was conducted to discover the transfer of oxygen to be the cause of emulsification, leading to a new study of a system with undergoing oxygen equilibration