Salvage radiotherapy for postoperative locoregional failure in esophageal cancer: a systematic review and meta-analysis.

Locoregional recurrences following surgery for esophageal cancers represent a significant clinical problem with no standard recommendations for management. We conducted this systematic review and meta-analysis with the objective of studying safety and efficacy of salvage radiotherapy in this setting. All prospective and retrospective cohort studies, which studied patients who developed locoregional recurrence following initial radical surgery for esophageal cancer and subsequently received salvage radiation therapy (RT)/chemoradiation with all relevant information regarding survival outcome and toxicity available, were included. The quality of eligible individual studies was assessed using the Newcastle-Ottawa Scale score for risk of bias. R package MetaSurv was used to obtain a summary survival curve from survival probabilities and numbers of at-risk patients collected at various time points and to test the overall heterogeneity using the I2 statistic. Thirty studies (27 retrospective, 3 prospective) published from 1995 to 2020 with 1553 patients were included. The median interval between surgery and disease recurrence was 12.5 months. The median radiation dose used was 60 Gy and 57% received concurrent chemotherapy. The overall incidence of acute grade 3/4 mucositis and dermatitis were 8 and 4%, respectively; grade 3/4 acute pneumonitis was reported in 5%. The overall median follow-up of all studies included was 27 months. The 1-, 2- and 3-year overall survival (OS) probabilities were 67.9, 35.9 and 30.6%, respectively. Factors which predicted better survival on multivariate analysis were good PS, lower group stage, node negativity at index surgery, longer disease-free interval, nodal recurrence (as compared to anastomotic site recurrence), smaller disease volume, single site of recurrence, RT dose >50 Gy, conformal RT, use of concomitant chemotherapy and good radiological response after radiotherapy. Salvage radiotherapy with or without concomitant chemotherapy for locoregional recurrences after surgery for esophageal cancer is safe and effective. Modern radiotherapy techniques may improve outcomes and reduce treatment-related morbidity.

Author Correction: On the processes influencing rapid intensity changes of tropical cyclones over the Bay of Bengal.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

On the processes influencing rapid intensity changes of tropical cyclones over the Bay of Bengal.

We present a numerical investigation of the processes that influenced the contrasting rapid intensity changes in Tropical Cyclones (TC) Phailin and Lehar (2013) over the Bay of Bengal. Our emphasis is on the significant differences in the environments experienced by the TCs within a few weeks and the consequent differences in their organization of vortex-scale convection that resulted in their different rapid intensity changes. The storm-relative proximity, intensity, and depth of the subtropical ridge resulted in the establishment of a low-sheared environment for Phailin and a high-sheared environment for Lehar. Our primary finding here is that in Lehar's sheared vortex, the juxtaposition in the azimuthal phasing of the asymmetrically distributed downward eddy flux of moist-entropy through the top of the boundary layer, and the radial eddy flux of moist-entropy within the boundary layer in the upshear left-quadrant of Lehar (40-80 km radius) establishes a pathway for the low moist-entropy air to intrude into the vortex from the environment. Conversely, when the azimuthal variations in boundary layer moist-entropy, inflow, and convection are weak in Phailin's low-sheared environment, the inflow magnitude and radial location of boundary layer convergence relative to the radius of maximum wind dictated the rapid intensification.

High-resolution gridded soil moisture and soil temperature datasets for the Indian monsoon region.

High-resolution soil moisture/temperature (SM/ST) are critical components of the growing demand for fine-scale products over the Indian monsoon region (IMR) which has diverse land-surface characteristics. This demand is fueled by findings that improved representation of land-state help improve rainfall/flood prediction. Here we report on the development of a high-resolution (4 km and 3 hourly) SM/ST product for 2001-2014 during Indian monsoon seasons (June-September). First, the quality of atmospheric fields from five reanalysis sources was examined to identify realistic forcing to a land data assimilation system (LDAS). The evaluation of developed SM/ST against observations highlighted the importance of quality forcing fields. There is a significant relation between the forcing error and the errors in the SM/ST. A combination of forcing fields was used to develop 14-years of SM/ST data. This dataset captured inter-annual, intra-seasonal, and diurnal variations under different monsoon conditions. When the mesoscale model was initialized using the SM/ST data, improved simulations of heavy rain events was evident, demonstrating the value of the data over IMR.

Improved prediction of severe thunderstorms over the Indian Monsoon region using high-resolution soil moisture and temperature initialization.

The hypothesis that realistic land conditions such as soil moisture/soil temperature (SM/ST) can significantly improve the modeling of mesoscale deep convection is tested over the Indian monsoon region (IMR). A high resolution (3 km foot print) SM/ST dataset prepared from a land data assimilation system, as part of a national monsoon mission project, showed close agreement with observations. Experiments are conducted with (LDAS) and without (CNTL) initialization of SM/ST dataset. Results highlight the significance of realistic land surface conditions on numerical prediction of initiation, movement and timing of severe thunderstorms as compared to that currently being initialized by climatological fields in CNTL run. Realistic land conditions improved mass flux, convective updrafts and diabatic heating in the boundary layer that contributed to low level positive potential vorticity. The LDAS run reproduced reflectivity echoes and associated rainfall bands more efficiently. Improper representation of surface conditions in CNTL run limit the evolution boundary layer processes and thereby failed to simulate convection at right time and place. These findings thus provide strong support to the role land conditions play in impacting the deep convection over the IMR. These findings also have direct implications for improving heavy rain forecasting over the IMR, by developing realistic land conditions.

Forages and Pastures Symposium: assessing drought vulnerability of agricultural production systems in context of the 2012 drought.

Weather and climate events and agronomic enterprise are coupled via crop phenology and yield, which is temperature and precipitation dependent. Additional coupling between weather and climate and agronomic enterprise occurs through agricultural practices such as tillage, irrigation, erosion, livestock management, and forage. Thus, the relationship between precipitation, temperature, and yield is coupled to the relationship between temperature, precipitation, and drought. Unraveling the different meteorological and climatological patterns by comparing different growing seasons provides insight into how drought conditions develop and what agricultural producers can do to mitigate and adapt to drought conditions. The 2012 drought in the United States greatly impacted the agricultural sector of the economy. With comparable severity and spatial extent of the droughts of the 1930s, 1950s, and 1980s, the 2012 drought impacted much of the U.S. crop and livestock producers via decreased forage and feed. This brief summary of drought impacts to agricultural production systems includes 1) the basics of drought; 2) the meteorology and climatology involved in forecasting, predicting, and monitoring drought with attribution of the 2012 drought explored in detail; and 3) comparative analysis completed between the 2011 and 2012 growing season. This synthesis highlights the complex nature of drought in agriculture production systems as producers prepare for future climate variability.

Hematological and biochemical studies of stephanofilarial dermatitis in naturally infected cattle of West Bengal, India.

This experimental study was conducted to assess the alterations in hematobiochemical values of cattle infected with stephanofilarial microfilariae. Hematological studies of infected cattle revealed significant (P<0.05) decrease in Hb%, PCV and TEC values whereas TLC values were significantly (P<0.05) increased. There was insignificant increase in lymphocyte concentration (%), significant (P<0.05) increase in eosinophil concentration (%) and insignificant decrease in neutrophil concentration (%) in infected cattle in relation to control animal. Biochemical studies revealed that the values of glucose, alkaline phosphatase, AST and ALT were significantly (P<0.05) increased in infected cattle than control cattle. However, the value of total serum protein was not affected.

Occurrence of organic chemicals in two rivers inhabited by Ozark hellbenders (Cryptobranchus alleganiensis bishopi).

Ozark Hellbender (Cryptobranchus alleganiensis bishopi) populations are in decrease throughout their native range with rare recruitment of young. Increased estrogenic chemical levels and alterations of physicochemical properties in their habitat may play a significant role in this phenomenon. We report here the first systematic, comprehensive study of organic chemical concentrations and physical and nutrient parameters in two rivers containing Ozark hellbender populations. Water samples were collected monthly from August 2003 to November 2004. Concentrations of 21 organic chemicals were determined using gas chromatography-mass spectrometry. Nine organic chemicals were detected. Benzyl butyl phthalate, dibutyl phthalate, bisphenol A, and beta-sitosterol were all detected >85% of the time, with median concentrations of 18 to 234 ng/L and maximum concentrations of 198 to 4141 ng/L. Individually, concentrations of nutrients and organic chemicals were much lower than those shown previously in laboratory and field experiments to have reproductive effects on amphibians. Nevertheless, hellbenders are exposed to a variety of chemicals with potential estrogenic effects. Our study establishes the basis to examine the specific effects of the detected concentrations, alone and in combination, on the Ozark hellbenders.

Analysis of normal electrocardiograms of Jamunapari goats.

In the present study, the normal electrocardiographic (ECG) values in the adult male Jamunapari breed of the goats were described. The mean heart rate in the goats was 127 +/- 3.46 per minute and ranged 107 and 168. The amplitudes and duration of various waveforms of ECG for six standard limb leads (I, II, III, aVL, aVR and aVF) were estimated. The overall P, QRS and T amplitudes (millivolts) were 0.065 +/- 0.01, 0.47 +/- 0.06 and 0.20 +/- 0.014 respectively. The duration (seconds) of these wave forms were 0.042 +/- 0.005, 0.033 +/- 0.002 and 0.10 +/- 0.014, respectively. The P-R interval and R-R intervals ranged between 0.06- 0.14 and 0.40-0.58 respectively. The average Q-T interval was 0.24 +/- 0.01 second, indicating the time for which the caprine ventricle remained depolarized. The corrected QT interval was also calculated which was found to vary from 0.24 to 0.57. The mean frontal plane vectors for the wave forms P, QRS and T wave forms were +49.99 +/- 6.02, +37.34 +/- 4.05 and +52.26 +/- 6.79 degrees respectively.