Radiation Therapy Treatment Outcomes for Patients with Head and Neck Cancer: a Tertiary Care Centre Experience in a Tier Three Town.

To report the outcomes of patients with head and neck squamous cell cancers (HNSCC) who received radiotherapy as a part of their first line treatment. All patients treated with radiotherapy for HNSCC between 2013 and 2017 were retrospectively identified from the department records. Patients with follow-up of less than 3 months following primary treatment were excluded. The demographic, disease and outcome details were retrieved from the patients' hospital records. The disease free survival (DFS) was estimated with Kaplan-Meier analysis, and effect of different variables on DFS were compared using log-rank test. The late toxicities of treatment were also recorded and reported. A total of 311 patients were found to be eligible. Most patients were males (82%), and oral cavity cancers predominated (45.3%). 237 patients (76.2%) had locally advanced disease at presentation. Radiotherapy was used as definitive treatment for 152 patients (48.9%). At a median follow up of 14.8 months (range: 3-85.2 months), the estimated Disease-Free Survival (DFS) was 52.7 months (95%CI: 37.7-67.7 months). Locally advanced disease correlated with a significantly lower median DFS (61.2 vs. 32.8 months; p = 0.01), but other factors, including gender, use of concurrent chemotherapy and adjuvant vs definitive radiotherapy appeared to have no statistical association with DFS. 181 (58.2%) patients had chronic RT-related toxicities at last follow-up, but most were generally mild, most frequently subcutaneous fibrosis (48.6%, which occurred significantly more frequently in patients receiving adjuvant RT following surgery- 40.8% versus 57.2%; p = 0.03) and xerostomia (32.4%). Radiation induced osteoradionecrosis was rare, occurring in only three (1%).Most HNSCC patients present with locally advanced disease, where disease control remains poor. Though there is substantial toxicity following treatment, the risk of severe toxicities with modern radiotherapy is low.

Interactions between candidate probiotics and the immune and antioxidative responses of European sea bass (Dicentrarchus labrax) larvae.

The use of lactic acid bacteria (LAB) as probiotics in aquaculture may improve the quality of seed production and limit the use of antibiotics in fish hatcheries. This study attempted to further characterize the candidate probiotic Lactobacillus casei X2, and the immune and physiological responses of the sea bass larvae. L. casei X2 was confirmed as a good candidate, due to its wide antibacterial spectrum against both Gram-positive and Gram-negative bacteria, and its free radical scavenging activity. In addition, if the strain did not seem able to form biofilm on abiotic surfaces, it adhered strongly to Hep-2 cells. However, these characteristics did not seem efficient in vivo. At 20 days post-hatch (dph), the expression level of CAT gene was significantly different between group fed without probiotic and the two groups treated with either Pediococcus acidilactici or L. casei. This gene was upregulated in the group treated with strain X2 and downregulated in the group with a commercial probiotic strain P. acidilactici, suggesting a better antioxidant activity with the later strain. At the same sampling date, the IL-1ß gene was upregulated in the group treated with P. acidilactici, and the HSP70 gene was overexpressed at 41 dph. As the stimulation of these two last genes, such transcriptomic indicators must be cautiously interpreted.

Consultant-Client Relationship and Knowledge Transfer in Small- and Medium-Sized Enterprises Change Processes.

Based on Szulanski's knowledge transfer model, this study examined how the communicational, motivational, and sharing of understanding variables influenced knowledge transfer and change processes in small- and medium-sized enterprises, particularly under projects developed by funded programs. The sample comprised 144 entrepreneurs, mostly male (65.3%) and mostly ages 35 to 45 years (40.3%), who filled an online questionnaire measuring the variables of "sharing of understanding," "motivation," "communication encoding competencies," "source credibility," "knowledge transfer," and "organizational change." Data were collected between 2011 and 2012 and measured the relationship between clients and consultants working in a Portuguese small- and medium-sized enterprise-oriented action learning program. To test the hypotheses, structural equation modeling was conducted to identify the antecedents of sharing of understanding, motivational, and communicational variables, which were positively correlated with the knowledge transfer between consultants and clients. This transfer was also positively correlated with organizational change. Overall, the study provides important considerations for practitioners and academicians and establishes new avenues for future studies concerning the issues of consultant-client relationship and the efficacy of Government-funded programs designed to improve performance of small- and medium-sized enterprises.

Age-related alterations in the lacrimal gland of adult albino rat: a light and electron microscopic study.

BACKGROUND: Age related changes in the lacrimal gland are associated with alterations in the structural organization and functional response in the gland of diverse mammalian species. Dry eye syndrome is one of the most common ocular problems in the world especially in old age. It results when the lacrimal gland fails to secrete proteins and fluid in sufficient quantity or appropriate composition. AIM OF THE WORK: The present study is designed to demonstrate the influence of aging on the structure of the lacrimal gland of albino rat and to provide a morphological basis to explain the pathogenesis of the dry eye syndrome with ageing. It also aims to carry out a comparative analysis of age-dependent changes in male and female rats and to address how the lacrimal gland ages in each sex. MATERIAL AND METHODS: Eighty albino rats were used in this study. The animals were divided into two age groups, young adult and senile. Tear secretion was measured using a modified Schirmer test. Corneal impression cytology of the anesthetized rats was done. The glands were subjected to gross morphologic examination, microscopic examination using H&E, PAS, Masson's trichrome and Giemsa stains. Electron microscopic examination was done in addition to quantitative histomorphometric estimations included acinar density, ductal count and mast cell count. RESULTS: Light microscopic examination of the lacimal glands of the senile rats revealed different pathological changes. These included acinar, ductal as well as stromal changes. Electron microscope examination of the lacrimal gland of the senile group showed a decrease in the electron dense secretory vesicles, mitochondrial swelling and lipofuscin-like inclusions were frequently seen in the cytoplasm of acinar cells in senile rats. CONCLUSION: The structural changes in the lacrimal glands of senile rats were associated with reduction in tear secretion as well as alterations in corneal epithelium. Gender difference in lacrimal gland structure was recorded.

A quantum chemistry study for ionic liquids applied to gas capture and separation.

In recent years, the global climate change is in evidence and it is almost a consensus that it is caused by the greenhouse gases emissions. An alternative to reduce these emissions is carbon capture and storage (CCS), which employs solvents based on amine compounds. In this scene, ionic liquids (IL) have been investigated to a greater extent for this application. In this work, we make an evaluation of interactions between gases (CO2, SO2, and H2S) and anion/cation from IL, as well as cation-anion interactions. For this, quantum calculations under vacuum were performed at the B3LYP/6-311+G** level of theory and using the M06-2X functional, where dispersion effects are considered. Among the well-studied systems based on imidazolium cations and fluorinated anions, we also studied the tetraalkylammonium, tetraalkylphosphonium, ether-functionalized imidazolium based systems, and tetrahexylammonium bis(trifluoromethanesulfonyl)imide, [THA][Tf2N], as a potential prototype. The ion pairs evaluated include [Tf2N](-)-based IL, with alkyl chain varying from [C1mim](+) to [C8mim](+) and [C1mim](+)-based IL. We found that the anion becomes more available to interact with gas with the weakening of the cation-anion interaction. [THA][Tf2N] has a binding energy of -274.89 kJ/mol at the B3LYP/6-311+G** level of theory, which is considered energetically interesting to gas capture applications.

Treatment of hypertriglyceridemia with fibric acid derivatives: impact on lipid subfractions and translation into a reduction in cardiovascular events.

This review investigates how the treatment of hypertriglyceridemia with fibric acid derivatives impacts lipid concentrations, lipid particle size, and the rate of cardiovascular events: expressly, to decide whether the use of fibric acid derivatives is an effective treatment option in the reduction of cardiovascular endpoints for patients with specific lipid parameters at baseline. Fibric acid derivatives reduce fasting triglyceride (TG) values by 15% to 50% (depending on baseline level) and low-density lipoprotein cholesterol (LDL-C) by 8%, and raise high-density lipoprotein cholesterol (HDL-C) by 9%. In conjunction with a statin, the amount of TG lowering is approximately doubled with the addition of the fibrate. When measured, fibrates decrease the TG concentration of very low-density lipoprotein cholesterol particles while increasing the TG content of LDL particles. The mean size of LDL particles increases and there is a substantial reduction in the number and proportion of small, dense LDL. In randomized trials in primary and secondary prevention populations, fibrates were associated with a significant reduction in nonfatal myocardial infarction in most studies. In the subgroup with elevated TG and/or depressed HDL-C at baseline, all trials have found statistically significant relative risk reductions of 27% to 65% in the primary cardiovascular endpoint of myocardial infarction and cardiovascular death.

Phase 2 study of single-agent IV vinflunine as third-line treatment of metastatic breast cancer after failure of anthracycline-/taxane-based chemotherapy.

OBJECTIVE: A multicenter, open-label, phase 2 study evaluated the efficacy and safety of intravenous vinflunine as third-line treatment in patients with progressing metastatic breast cancer (MBC) after failure of anthracycline- and taxane-based chemotherapy. PATIENTS AND METHODS: Fifty-six patients with MBC, relapsing after receiving 2 previous treatments for advanced disease, including both anthracyclines and taxanes, received 320 mg/m(2) of vinflunine once every 3 weeks (median number of 2.5 cycles, range: 1-13). RESULTS: According to an independent radiologist, the response rate was 12.5% (95% CI: 5.2-24.1) and 14% (95% CI: 5.3-27.9) (6 partial responses) in the treated and evaluable populations, respectively. Disease control was achieved in 42.9% and 51.2% of the patients, respectively. Median progression-free survival was 2.6 months (95% CI: 1.6-4.0 months) with a median overall survival of 11.4 months (95% CI: 7.4-14.2 months). Duration of response was 6.8 months (95% CI: 5.6 months, upper limit not reached). Leukopenia was the most frequent hematologic toxicity, with grade 3/4 severity in 49.1% of the patients. Grade 3 neutropenia in 30.9%, grade 4 in 40.0% of patients, febrile neutropenia (5.4%), and 1 case of neutropenia infection (1.8%) were reported. Other grade 3 toxicities included anemia (5.5%), fatigue (14.3%), and constipation (7.1%), which were noncumulative. The adverse events associated with vinflunine were predictable and manageable. CONCLUSIONS: Vinflunine is an active and well-tolerated agent as third-line treatment of patients with MBC after failure of anthracycline- and taxane-based therapy. These results warrant further investigation of vinflunine monotherapy or in combination for the treatment of MBC.

Selectivity in ligand recognition of G-quadruplex loops.

A series of disubstituted acridine ligands have been cocrystallized with a bimolecular DNA G-quadruplex. The ligands have a range of cyclic amino end groups of varying size. The crystal structures show that the diagonal loop in this quadruplex results in a large cavity for these groups, in contrast to the steric constraints imposed by propeller loops in human telomeric quadruplexes. We conclude that the nature of the loop has a significant influence on ligand selectivity for particular quadruplex folds.

Endothelial vesiculo-vacuolar organelles, pockets and multi-layered fenestrated lamellae in the capillaries of the mouse carotid body.

Fenestrated capillaries represent the basic structural unit in the carotid body. They mediate a characteristic hyperpermeability state in this organ. Endothelial fenestrae and plasmalemmal vesicles are of particular importance in this respect. The present electron microscopic study of the capillaries of the mouse carotid body demonstrates prominent endothelial cell structures that are suggested to be closely related to endothelial fenestrae and plasmalemmal vesicles. These structures include: (1) Vesiculo-vacuolar organelles formed by fusion and intercommunication of vesicles and vacuoles of variable dimensions. (2) Pockets in the form of fenestrated membrane-bound vacuoles that communicate either with the capillary lumen, pericapillary space or both via multiple apertures or fenestrae. (3) Multi-layered fenestrated Lamellae where the endothelial cytoplasm is divided into multiple attenuated sheets provided with several fenestrae. The latter two structures are preferentially located in the thick perinuclear region of the endothelial cell. Their fenestrae are always distributed in linear series and show close similarity to the usual chains of fenestrae in the attenuated periphery of the endothelial cells. The individual apertures of the fenestrated vacuoles and multi-layered fenestrated lamellae are closely similar to the stomata of fully opened plasmalemmal vesicles suggesting a relationship between them. Morphological and morphometrical analysis of a series of fenestrae belonging to these structures revealed that they are identical to the usual chains of fenestrae in the attenuated periphery of the endothelial cells.

The spatial relationship between type I glomus cells and arteriolar myocytes in the mouse carotid body.

The structural relationship between type I glomus cells and the vascular smooth muscle was investigated by electron microscopy in the mouse carotid body. A close apposition (<0.1 microm) between the glomus parenchyma and the neighbouring arterioles was regularly present. Profiles of type I glomus cells were found to be exposed to the vascular smooth muscle without any supporting cell investment. In circumscribed areas of these profiles, type I glomus cells and the vascular smooth muscle cells made contact by fusion of their basal laminae. These glomus-cell-myocyte junctions structurally resemble vascular neuromuscular junctions of sympathetic nerve terminals. In addition to the occurrence of such glomus cell-myocyte contacts, myoendothelial junctions also appeared frequently. On the basis of these observations, it is suggested that type I glomus cells play a role in the regulation of the vascular tone in the carotid body and that a physiological interaction between the endothelial cells, the vascular smooth muscle cells and the type I glomus cells exists.