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Early laryngeal cancer treated with definitive radiotherapy or surgery has a high cure rate. This study evaluated the patterns of treatment failure and long-term results of early laryngeal cancers treated with definitive radiotherapy.
From January 2002 to December 2014, a total of 242 patients with early-stage laryngeal cancers were treated with radical radiotherapy.
All patients had squamous cell carcinoma of the larynx (92 per cent male and 8 per cent female). Median follow-up was 4.5 years. The majority of patients were smokers (57.4 per cent). Local failure was seen in 12.5 per cent of stage I patients and 22.8 per cent of stage II patients. The 5-year overall survival and disease specific survival were 84 per cent and 91 per cent, respectively.
In summary, radiotherapy is a suitable treatment modality for patients with early-stage laryngeal cancer, with an overall locoregional control rate of 84 per cent. Patients who fail radiotherapy may still undergo salvage laryngectomy.
The present study aimed to assess the antioxidant and oxidant status of goats naturally infected with Haemonchus contortus. Based upon the parasite burden, infection in goats was categorized as heavy (> 500 worms), mild (100–500 worms) or low (< 100 worms). Abomasal tissues from non-infected and infected goats were used for the determination of catalase (CAT), glutathione S-transferase (GST), glutathione reductase (GR), glutathione peroxidase (GPx), aspartate (AST) and alanine (ALT) aminotransferases, acid (ACP) and alkaline (ALP) phosphatases, superoxide content (O2−), protein carbonyl (PC), malondialdehyde (MDA) and reduced glutathione (GSH). A significantly higher level of CAT, GST and GR activity and a lower level of GPx activity were recorded in infected compared to non-infected tissue. A significant increase in the level of AST, ALT, ALP and ACP was found in the abomasal tissue of the infected animals, which was related to the worm burden. The oxidative stress markers were also altered, with a significant decline in GSH levels, whereas MDA, PC and O2− concentrations showed a marked increase. In conclusion, it has been demonstrated that haemonchosis in goats resulted in considerable oxidative stress, which was directly related to the worm burden.
Exposure to the endocrine disruptor bisphenol A (BPA) is ubiquitous and associated with health abnormalities that persist in subsequent generations. However, transgenerational effects of BPA on metabolic health are not widely studied. In a maternal C57BL/6J mice (F0) exposure model using BPA doses that are relevant to human exposure levels (10 μg/kg/day, LowerB; 10 mg/kg/day, UpperB), we showed male- and dose-specific effects on pancreatic islets of the first (F1) and second generation (F2) offspring relative to controls (7% corn oil diet; control). In this study, we determined the transgenerational effects (F3) of BPA on metabolic health and pancreatic islets in our model. Adult F3 LowerB and UpperB male offspring had increased body weight relative to Controls, however glucose tolerance was similar in the three groups. F3 LowerB, but not UpperB, males had reduced β-cell mass and smaller islets which was associated with increased glucose-stimulated insulin secretion. Similar to F1 and F2 BPA male offspring, staining for markers of T-cells and macrophages (CD3 and F4/80) was increased in pancreas of F3 LowerB and UpperB male offspring, which was associated with changes in cytokine levels. In contrast to F3 BPA males, LowerB and UpperB female offspring had comparable body weight, glucose tolerance and insulin secretion as Controls. Thus, maternal BPA exposure resulted in fewer metabolic defects in F3 than F1 and F2 offspring, and these were sex- and dose-specific.
The causative agent of urogenital schistosomiasis, Schistosoma haematobium, was thought to be the only schistosome species transmitted through Bulinus snails on Unguja and Pemba Island (Zanzibar, United Republic of Tanzania). For insights into the environmental risk of S. haematobium transmission on Pemba Island, malacological surveys collecting Bulinus globosus and B. nasutus, two closely related potential intermediate hosts of S. haematobium were conducted across the island in November 2016. Of 1317 B. globosus/B. nasutus collected, seven B. globosus, identified through sequencing a DNA region of the mitochondrial cytochrome oxidase subunit 1 (cox1), were observed with patent infections assumed to be S. haematobium. However, when the collected cercariae were identified through sequencing a region of the cox1 and the nuclear internal transcribed spacer (ITS1 + 2), schistosomes from five of these B. globosus collected from a single locality were in fact S. bovis. The identified presence of S. bovis raises concerns for animal health on Pemba, and complicates future transmission monitoring of S. haematobium. These results show the pertinence for not only sensitive, but also species-specific markers to be used when identifying cercariae during transmission monitoring, and also provide the first molecular confirmation for B. globosus transmitting S. bovis in East Africa.
Royal Jelly (RJ) is product from bees that is used to feed larvae in the hive as well as a main nutritional source for the queen honey bee. It has various important biological activities including as an antioxidant, immunomodulatory, anti-inflammatory, antimicrobial, cholesterol-lowering, and growth promoter activities and has the ability for inhibition of certain enzymatic degradation. It can be used for the improvement of growth performance, gut health and quality and safety of animal products in poultry due to its antioxidant and immune modulating properties. The antioxidant activity of RJ is mainly due to the presence of polyphenolic compounds. It is an excellent source of B and C vitamins and folic acid. The mineral profile of RJ is useful as it contains major macro and micro minerals. Studies conducted on supplementation with RJ in poultry diets have shown a significant increase in body weight, egg production, and immune levels and is especially useful in organic production. Supplementation of RJ at the level of 10 and 15 mg/kg in layer diets positively influenced egg weight (by 5.0% and 4.8% respectively), egg production (10.5% and 11.0% respectively), weight gain of hens (7.0% and 6.5% respectively) and yolk pigmentation (9.5% and 9.7% respectively). Total leukocyte and erythrocyte counts in the diet containing 200 mg/kg RJ were significantly higher than the diet contained 100 mg/kg or the unsupplemented control group. However, the heterophil/lymphocyte ratio and heterophil percent were reduced in RJ-fed groups. Supplementing poultry diets with RJ offers an opportunity to maximise profit from safe and high quality poultry production.
The definition of severe acute respiratory infection (SARI) – a respiratory illness with fever and cough, occurring within the past 10 days and requiring hospital admission – has not been evaluated for critically ill patients. Using integrated electronic health records data, we developed an automated search algorithm to identify SARI cases in a large cohort of critical care patients and evaluate patient outcomes. We conducted a retrospective cohort study of all admissions to a medical intensive care unit from August 2009 through March 2016. Subsets were randomly selected for deriving and validating a search algorithm, which was compared with temporal trends in laboratory-confirmed influenza to ensure that SARI was correlated with influenza. The algorithm was applied to the cohort to identify clinical differences for patients with and without SARI. For identifying SARI, the algorithm (sensitivity, 86.9%; specificity, 95.6%) outperformed billing-based searching (sensitivity, 73.8%; specificity, 78.8%). Automated searching correlated with peaks in laboratory-confirmed influenza. Adjusted for severity of illness, SARI was associated with more hospital, intensive care unit and ventilator days but not with death or dismissal to home. The search algorithm accurately identified SARI for epidemiologic study and surveillance.
Otowicks are used to treat otitis externa with significant ear canal oedema. This study investigates how well drops penetrate through to reach the deep canal and whether it is safe to leave otowicks in the canal for more than 2 days.
Sterile otowicks were inserted into mock ear canals and vertically over pseudomonas-seeded agar plates whilst gentamicin or ciprofloxacin drops were administered. The time taken for drops to penetrate through the otowick was recorded. Separately, pseudomonas-seeded otowicks were treated with saline or antibacterial drops. The penetrating drops were observed for bacterial growth on sterile agar.
It took six drops before penetration occurred for both antibiotics. When sterile saline drops were applied to bacterially contaminated otowicks, the penetrating drops displayed bacterial growth on agar, indicating that pseudomonas penetrated through the otowick. However, when antibiotic drops were applied, penetrating drops showed no bacterial growth on the corresponding agar plate.
Bacteria can penetrate otowicks but this is prevented by continuous application of antibacterial ear drops. Ear wicks need priming with six drops before starting a regimen, so that the initial dose is fully absorbed.
Elevated birth weight is linked to glucose intolerance and obesity health-related complications later in life. No studies have examined if infant birth weight is associated with gene expression markers of obesity and inflammation in a tissue that comes directly from the infant following birth. We evaluated the association between birth weight and gene expression on fetal programming of obesity. Foreskin samples were collected following circumcision, and gene expression analyzed comparing the 15% greatest birth weight infants (n=7) v. the remainder of the cohort (n=40). Multivariate linear regression models were fit to relate expression levels on differentially expressed genes to birth weight group with adjustment for variables selected from a list of maternal and infant characteristics. Glucose transporter type 4 (GLUT4), insulin receptor substrate 2 (IRS2), leptin receptor (LEPR), lipoprotein lipase (LPL), low-density lipoprotein receptor-related protein 1 (LRP1), matrix metalloproteinase 2 (MMP2), plasminogen activator inhibitor-1 (PAI-1) and transcription factor 7-like 2 (TCF7L2) were significantly upregulated and histone deacetylase 1 (HDAC1) and thioredoxin (TXN) downregulated in the larger birth weight neonates v. controls. Multivariate modeling revealed that the estimated adjusted birth weight group difference exceeded one standard deviation of the expression level for eight of the 10 genes. Between 25 and 50% of variation in expression level was explained by multivariate modeling for eight of the 10 genes. Gene expression related to glycemic control, appetite/energy balance, obesity and inflammation were altered in tissue from babies with elevated birth weight, and these genes may provide important information regarding fetal programming in macrosomic babies.
The oriental army worm Mythimna separata (Lepidoptera: Noctuidae) is a migratory pest in Eastern Asia and China. Seasonal high temperatures in Southern China and low temperatures in Northern China are pressures favouring the annual migration of this species, while cold tolerance determines the northern limit of its overwintering range. A number of physiological stress responses occur in insects as a result of variations in temperature. One reaction to thermal stress is the generation of reactive oxygen species (ROS), which can be harmful by causing oxidative damage. The time-related effects (durations of 1, 4 and 7 h) of thermal stress treatments of M. separata at comparatively low (5, 10, 15 and 20°C) and high (30, 35, 40 and 45°C) temperatures on the activities of antioxidant enzymes, including superoxide dismutase (SOD), catalase (CAT), peroxidase (POX) and glutathione S-transferases (GSTs), and total antioxidant capacity (T-AOC) were determined. Thermal stress resulted in significant elevation of the activities of SOD, CAT and GSTs, indicating that these enzymes contribute to defence mechanisms counteracting oxidative damage caused by an increase in ROS. However, at high-temperatures, POX and T-AOC were also found to contribute to scavenging ROS. Our results also indicate that extreme temperatures lead to elevated ROS production in M. separata. The present study confirms that thermal stress can be responsible for oxidative damage. To overcome such stress, antioxidant enzymes play key roles in diminishing oxidative damage in M. separata.
Remittances to developing countries sent through official channels were estimated at USD 406 billion in 2012 (World Bank, 2012). This represents a growth of 6.5 per cent over 2011 and is projected to rise by 8 per cent in 2013 and 10 per cent in 2014. Current remittance flows are over three times the amount of official development assistance (World Bank, 2012). In Pakistan, remittances through official channels have grown from just around USD 1.5 billion in 1997/98 to slightly over USD 13 billion in 2011/12 (State Bank of Pakistan, n.d.; see also Table 11.1). In the first six months (July– December 2012), they were slightly over USD 7 billion—an increase of 12 per cent over the corresponding period in the previous year (July–December 2011).
An earlier study (Amjad, Arif, & Irfan, 2012) analyzes the possible reasons for this manifold increase and in its preliminary findings suggests that the increase is primarily due to (i) a shift from unofficial (and unrecorded) channels (hawala) to official channels; (ii) an increase in the number of migrants abroad; and (iii) a rise in migrants' skill levels, resulting in higher wages and incomes abroad. The study also makes the important observation that the inflow of remittances is not just from Pakistani workers abroad but from the larger Pakistani diaspora, many of whom may have acquired nationality of their country of residence. The study also infers that official remittance flows also reflect shifts in the diaspora's savings and assets to their home country.
Amjad et al. (2012) also attempt a rough estimate of the volume of remittances coming through both official and unofficial channels. This is based on estimates of the size of the Pakistani diaspora, as reported by different sources, as well as the average volume of remittances sent, based on recent survey data. The range of these estimates suggests that total remittances could be as high as 180 per cent of official recorded remittances.
Electronic health records (EHRs) may contain infomarkers that identify patients near the end of life for whom it would be appropriate to shift care goals to palliative care. Discovery and use of such infomarkers could be used to conduct effectiveness research that ultimately could help to reduce the monumental cost of caring for the dying. The aim of our study was to identify changes in the plans of care that represent infomarkers, which signal a transition of care goals from nonpalliative care ones to those consistent with palliative care.
Using an existing electronic health record database generated during a two-year longitudinal study of nine diverse medical–surgical units from four Midwest hospitals and a known group approach, we evaluated patient care episodes for 901 patients who died (mean age = 74.5 ± 14.6 years). We used ANOVA and Tukey's post-hoc tests to compare patient groups.
We identified 11 diagnoses, including Death Anxiety and Anticipatory Grieving, whose addition to the care plan, some of which also occurred with removal of nonpalliative care diagnoses, represent infomarkers of transition to palliative care goals. There were four categories of patients, those who had: no infomarkers on plans (n = 507), infomarkers added on the admission plan (n = 194), infomarkers added on a post-admission plan (minor transitions, n = 109), and infomarkers added and nonpalliative care diagnoses removed on a post-admission plan (major transition, n = 91). Age, length of stay, and pain outcomes differed significantly for these four categories of patients.
Significance of Results:
EHRs contain pertinent infomarkers that if confirmed in future studies could be used for timely referral to palliative care for improved focus on comfort outcomes and to identify palliative care subjects from data repositories in order to conduct big-data research, comparative effectiveness studies, and health-services research.
Otic barotrauma is common among air travellers and can cause severe otalgia, perforation of the tympanic membrane and hearing loss. Many prevention measures exist, with varying evidence to support their use. There are no data to establish if air travellers are aware of them or indeed use them. We aimed to establish air travellers' knowledge of such prevention measures.
We surveyed air travellers at two UK airports by means of a questionnaire. Answers to the questionnaire were collected over a two-week period.
Overall, 179 air travellers with a mean age of 28 years (range: 15–72 years) completed the questionnaire. There were 66 female and 113 male air travellers. The majority (84 per cent) complained of symptoms while flying and 30 per cent were not aware of any prevention measures. Barotrauma-related symptoms were reported in 25 per cent of air travellers who were unaware of any prevention measures. Nearly all air travellers (86 per cent) indicated that more information regarding prevention measures would be useful.
Air travellers are often not aware of prevention measures to avoid otic barotrauma, and the majority suffer as a result. Increasing public awareness of simple prevention measures would have a significant impact on air travellers.
Amid declining shark populations because of overfishing, a burgeoning shark watching industry, already well established in some locations, generates benefits from shark protection. We compile reported economic benefits at shark watching locations and use a meta-analytical approach to estimate benefits at sites without available data. Results suggest that, globally, c. 590,000 shark watchers expend > USD 314 million per year, directly supporting 10,000 jobs. By comparison, the landed value of global shark fisheries is currently c. USD 630 million and has been in decline for most of the past decade. Based on current observed trends, numbers of shark watchers could more than double within the next 20 years, generating > USD 780 million in tourist expenditures around the world. This supports optimistic projections at new sites, including those in an increasing number of shark sanctuaries established primarily for shark conservation and enacted in recognition of the ecological and economic importance of living sharks.
Experiment was conducted to evaluate the effect of weaning age on growth performance, feed intake, feed efficiency (FE) and blood metabolites in Nili-Ravi male buffalo (Bubalus bubalis) calves. Twenty-four male buffalo calves were assigned to one of the three treatment groups: continuous milk feeding (CMF), limited milk feeding (LMF) and early weaning (EW), and weaned off milk at 12, 10 and 8 weeks of age, respectively. For the first 3 days after birth, calves in all three treatments were fed colostrum, and were then moved to individual milk feeding at 10% of BW for the next 6 weeks. Thereafter, the provision of milk to the CMF group was gradually tapered to zero through week 12, using week 6 intakes as a base. The LMF calves were fed milk at 7.5%, 5.0%, 3.5%, and 1.5% of BW during weeks 7 to 10, respectively. Lastly, calves in the EW group were fed milk at 5.0% and 2.5% of BW at weeks 7 and 8, respectively. Calf starter (CS) feed was also provided ad libitum from weeks 2 to 12 and individual intakes were recorded on a daily basis. Blood samples were taken from weeks 6 to 12, on a weekly basis; whereas, the BW, heart girth, withers height and hip width were measured at the start of experiment and later on a weekly basis. Weight gain, average daily gain, and body measurements were the same across all three groups. Milk intake was lower (P < 0.05), whereas CS intake was greater (P < 0.05) in the EW calves compared with the other treatment groups. Dry matter intake was greater (P < 0.05) in the EW and LMF calves compared with the CMF calves. The FE was greater (P < 0.05) in the CMF calves compared with the LMF and EW treatment groups. Blood glucose concentration was similar among the treatments; however, blood urea nitrogen was greater (P < 0.05) in the EW calves compared with the CMF and LMF groups. Plasma concentration of non-esterified fatty acids was higher (P < 0.05) in the EW calves compared with the CMF calves. In light of these results, it is evident that buffalo calves can be successfully weaned as early as 8 weeks of age without negatively affecting their growth performance.
Recently there have been a number of reports indicating concern relating to the effect of porosity, pore size distribution, and pore interconnectivity on the integration of highly porous ultra low-k organosilicate glasses (OSGs) as back-end-of-line (BEOL) interconnect dielectrics. In an effort to address these concerns a number of options to control the skeleton and pore structure of OSGs have been proposed, from adding alternative OSG precursors to alternative porogen precursors. In all these options there is a need to balance pore structure modification with critical film properties such as dielectric constant and mechanical strength. In this context, this paper examines porosity and its impact on film properties for highly porous ultra low dielectric constant films. A series of PDEMS® porous OSG films were deposited by plasma enchanced chemical vapor deposition (PECVD) from DEMS® precursor (diethoxymethylsilane) and porogen ATRP (alpha-terpenine). The percent porosity and pore interconnectivity of these films relative to the dielectric constant were measured by ellipsometric porosimetry (EP) and positron annihilation spectroscopy (PALS) respectively. Porosity and pore-size distribution for films deposited using several different species (structure former or porogen precursors) were examined using EP in an effort to understand the impact of the chemical nature of the precursor on pore morphology. Results from these depositions show that it is possible to deposit films with smaller pores using alternative structure formers (ASFs) with bulky organic groups, although there are tradeoffs with respect to other film characteristics. The addition of a separate porogen (ATRP) to the ASF lowered the dielectric constant and the addition of DEMS® precursor to the ASF/ATRP mix gave the films added structural integrity and mechanical strength. Such a fundamental understanding of structure-property relationships will help support successful integration of these porous OSG films.
In recent years, livestock producers have been supplementing animal diets with fish meal (FM) to produce value-added products for health conscious consumers. As components of FM have unique neuroendocrine–immunomodulatory properties, we hypothesize that livestock producers may be influencing the overall health of their animals by supplementing diets with FM. In this study, 40 pregnant ewes were supplemented with rumen protected (RP) soybean meal (SBM: control diet) or RP FM, commencing gestation day 100 (gd100), in order to evaluate the impact of FM supplementation on the innate and acquired immune response and neuroendocrine response of sheep during pregnancy and lactation. On gd135, half the ewes from each diet (n = 10 FM, n = 10 SBM) were challenged iv with lipopolysaccharide (LPS) to simulate a systemic bacterial infection and the febrile, respiratory and neuroendocrine responses were monitored over time; the other half (n = 10 FM, n = 10 SBM) of the ewes received a saline injection as control. On lactation day 20 (ld20), all ewes (n = 20 FM, n = 20 SBM) were sensitized with hen egg white lysozyme (HEWL) and the serum haptoglobin (Hp) response was measured over time. The cutaneous hypersensitivity response (CHR) to HEWL challenge was measured on ld30 (n = 20 FM, n = 20 SBM), and blood samples were collected over time to measure the primary and secondary immunoglobulin G (IgG) response to HEWL. There was an attenuated trend in the LPS-induced febrile response by the FM treatment when compared with the SBM treatment (P = 0.06), as was also true for the respiratory response (P = 0.07), but significant differences in neuroendocrine function (serum cortisol and plasma ACTH) were not observed between treatments. Basal Hp levels were significantly lower in the FM supplemented ewes when compared with the SBM supplemented ewes (P < 0.01), and the Hp response to HEWL sensitization differed significantly over time between treatments (P < 0.01). The CHR to HEWL was also significantly attenuated in the FM treatment compared with the SBM (P < 0.01); however, treatment differences in the primary and secondary IgG responses to HEWL were not observed. These results indicate that FM supplementation differentially affects the innate and acquired immune responses in pregnant and lactating sheep compared with a typical SBM diet of commercial flocks. The long-term implications of this immunomodulation warrant further investigation.