Systematic review of survival following liver or lung metastasectomy for metastatic anal squamous cell carcinoma.

INTRODUCTION: Metastatic anal squamous cell carcinoma (SCC) carries a poor prognosis and the evidence base for surgical resection of metastases remains limited. The aim of this study was to establish the survival outcomes for patients undergoing metastasectomy for anal SCC. METHODS: A systematic review was performed using the MEDLINE®, Embase®, Cochrane and PubMed® databases. Studies were considered for inclusion in the review if they involved patients aged >18 years with a diagnosis of stage IV anal SCC who underwent metastasectomy for liver and/or lung metastases. The primary outcome measure was overall survival. Secondary outcome measures were disease free survival, early morbidity according to the Clavien-Dindo classification and quality of life, measured using a validated scoring tool. Risk of bias was assessed with the ROBINS-I (Risk Of Bias In Non-randomised Studies - of Interventions) tool. RESULTS: There were 10 studies with a total of 98 patients. There was heterogeneity in results reporting, with recurrence free survival the most reported outcome. For all studies reporting on liver metastasectomy, the one-year overall survival rate was 87%. In studies with adequate follow-up reported, the three and five-year overall survival rates were 53% and 38% respectively. Only one study reported on lung metastasectomy patients; the overall median survival was 24 months. None of the studies reported on quality of life measures. The ROBINS-I tool identified a critical risk of bias in six studies, a serious risk in one study and a moderate risk in three studies. CONCLUSIONS: The evidence base for metastasectomy in metastatic anal SCC is limited. Further information is required to inform future treatment methods and use of a standardised outcomes reporting method is needed to support this.

Global monitoring of volcanic SO2 degassing with unprecedented resolution from TROPOMI onboard Sentinel-5 Precursor.

Over the last four decades, space-based nadir observations of sulfur dioxide (SO2) proved to be a key data source for assessing the environmental impacts of volcanic emissions, for monitoring volcanic activity and early signs of eruptions, and ultimately mitigating related hazards on local populations and aviation. Despite its importance, a detailed picture of global SO2 daily degassing is difficult to produce, notably for lower-tropospheric plumes, due largely to the limited spatial resolution and coverage or lack of sensitivity and selectivity to SO2 of current (and previous) nadir sensors. We report here the first volcanic SO2 measurements from the hyperspectral TROPOspheric Monitoring Instrument (TROPOMI) launched in October 2017 onboard the ESA's Sentinel-5 Precursor platform. Using the operational processing algorithm, we explore the benefit of improved spatial resolution to the monitoring of global volcanic degassing. We find that TROPOMI surpasses any space nadir sensor in its ability to detect weak degassing signals and captures day-to-day changes in SO2 emissions. The detection limit of TROPOMI to SO2 emissions is a factor of 4 better than the heritage Aura/Ozone Monitoring Instrument (OMI). Here we show that TROPOMI SO2 daily observations carry a wealth of information on volcanic activity. Provided with adequate wind speed data, temporally resolved SO2 fluxes can be obtained at hourly time steps or shorter. We anticipate that TROPOMI SO2 data will help to monitor global volcanic daily degassing and better understand volcanic processes and impacts.

Social cohesion, condom use, and sexually transmitted infections among female sex workers living with HIV in the Dominican Republic.

This cross-sectional study examines the relationship between social cohesion with consistent condom use (CCU) and sexually transmitted infections (STIs) among the Abriendo Puertas (Opening Doors) cohort of female sex workers (FSWs) living with human immunodeficiency virus (HIV) in the Dominican Republic (n = 228). Using data from the follow-up survey of the cohort, we conducted multivariate logistic regression to explore these dynamics. Social cohesion was significantly associated with CCU between FSWs living with HIV and their clients in the last month (adjusted odds ratio [AOR] = 1.65, 95% confidence interval [CI]: 1.11-2.45) and STI prevalence among FSWs (AOR: 3.76, CI: 1.159-12.162). Social cohesion was not associated with CCU between FSWs living with HIV and their steady partners. However, both illicit drug use in the past six months (AOR = 0.11, CI: 0.023-0.57) and pregnancy intentions (AOR = 0.11; CI: 0.02-0.42) were significantly associated with CCU with steady partners. Findings highlight the differential role of social cohesion on condom use outcomes between FSWs living with HIV and their paying clients versus steady partners. Research on the pathways via which cohesion influences condom use among sex workers and their clients is merited, as is research regarding the role of drug use and pregnancy intentions on condom use with steady partners.

Understanding social and sexual networks of sexual minority men and transgender women in Guatemala city to improve HIV prevention efforts.

Sexual minority men and transgender women are disproportionately affected by HIV in Guatemala. Innovative prevention strategies are urgently needed to address these disparities. While social network approaches are frequently used to reach sexual minorities, little is known about the unique network characteristics among sub-groups. We conducted in-depth qualitative interviews with 13 gay-identifying men, eight non-gay-identifying men who have sex with men (MSM) and eight transgender women in Guatemala City. Using narrative and thematic coding procedures, we identified distinct patterns in the size, composition, and overlap between social and sexual networks across groups. Gay-identifying men had the largest, most supportive social networks, predominantly comprising family. For both non-gay-identifying MSM and transgender women, friends and sex clients provided more support. Transgender women reported the smallest social networks, least social support, and the most discrimination. HIV prevention efforts should be tailored to the specific sexual minority population and engage with strong ties.

The bonding electron density in aluminum.

Aluminum is considered to approach an "ideal" metal or free electron gas. The valence electrons move freely, as if unaffected by the presence of the metal ions. Therefore, the electron redistribution due to chemical bonding is subtle and has proven extremely difficult to determine. Experimental measurements and ab initio calculations have yielded substantially different results. We applied quantitative convergent-beam electron diffraction to aluminum to provide an experimental determination of the bonding electron distribution. Calculation of the electron distribution based on density functional theory is shown to be in close agreement. Our results yield an accurate quantitative correlation between the anisotropic elastic properties of aluminum and the bonding electron and electrostatic potential distributions.

Local understanding of an HIV vaccine and its relationship with HIV-related stigma in the Dominican Republic.

The purpose of this study was to explore local perceptions and experiences regarding vaccines in general and HIV vaccines and vaccine trials in the Dominican Republic. In-depth interviews were carried out with 25 participants representing two study groups: (1) individuals considered at high risk for HIV infection including female sex workers and male STI clinic attendees and (2) individuals considered at low risk of HIV infection including women and men recruited at a general outpatient clinic. Across the groups, participants often characterized vaccines in general as having both preventive and curative properties. In turn, one of the most salient concerns regarding the receipt of an HIV vaccine was the fear that one would be labelled 'HIV positive' and stigmatized, as the vaccine may be perceived as a cure for those already infected. These findings suggest the importance of individual and community level education to clarify the nature and mechanisms of the given HIV vaccine being tested. Social support and counselling services should also accompany HIV vaccine trials and distribution plans to assist individuals in determining if and how they communicate their participation and/or receipt of an HIV vaccine to others and manage potential negative social reactions.

New horizons in military dental laboratory training.

Dental laboratory training has taken on a new look for the military. As a result of numerous cost analyses Air Force, Navy, and Army training has been combined under one roof. All three services have molded their courses together to form a tri-service training program at Sheppard AFB in Wichita Falls, Texas. Graduation of the first class occurred on June 24, 1998. A 6 month basic course, as well as several advanced concept courses are offered by the program. Instructors from all branches of service are represented on staff to teach. The facility is state of the art and was built in 1991 to provide for Air Force Dental Training. Downsizing of today's military has resulted in dental training coming together to provide one quality course to military individuals qualified to enroll, thus ensuring tomorrow's laboratory technicians will be as qualified as those in the past.