Causes of death in patients with locally advanced head and neck cancer treated with radiotherapy and systemic therapy.

BACKGROUND: To investigate the incidence of non-cancer mortalities and prognostic factors associated with competitive causes of death in a homogeneous cohort of patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment. METHODS: This study included 284 patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment between 2005 and 2017. The cumulative incidence of death associated with tumour, second tumours, treatment, side effects and comorbidity was calculated. A Fine and Gray regression model was used to investigate factors associated with cancer and competitive mortality. RESULTS: The cumulative incidence of tumoral death at 5 and 10 years were 35 and 47% respectively, whereas the cumulative incidence of competitive mortality were 10 and 12% respectively. In the multivariate analysis, age and comorbidity were independent factors for non-cancer mortality. Patients with a high risk of non-cancer mortality presented a cumulative incidence of 17.3% at 5 years and 18.4% at 10 years. CONCLUSIONS: This study demonstrated a high incidence of competing mortality in older patients with comorbidities. Non-cancer deaths should be considered when selecting patients for combination therapies and in the study design ofclinical trials.

The volcano mouse Neotomodon alstoni of central Mexico, a biological model in the study of breeding, obesity and circadian rhythms.

The "Mexican volcano mouse" Neotomodon alstoni, is endemic of the Transverse Neovolcanic Ridge in central Mexico. It is considered as least concern species and has been studied as a potential laboratory model from different perspectives. Two lines of research in neuroendocrinology have been addressed: reproduction and parental care, particularly focused on paternal attention and the influence of testosterone, and studies on physiology and behavior of circadian rhythms, focused on the circadian biology of the species, its circadian locomotor activity and daily neuroendocrine regulation of metabolic parameters related to energy balance. Some mice, when captive, spontaneously develop obesity, which allows for comparisons between lean and obese mice of daily changes in neuronal and metabolic parameters associated with changes in food intake and locomotor activity. This review includes studies that consider this species an attractive animal model where the alteration of circadian rhythms influences the pathogenesis of obesity, specifically with the basic regulation of food intake and metabolism and differences related to sex. This study can be considered as a reference to the comparative animal physiology among rodents.

Zika virus epidemiology: from Uganda to world pandemic, an update.

Zika virus (ZIKV) infection is an emergent worldwide public health problem. Historically, 84 countries have reported vector-borne ZIKV transmission, 61 of which report on-going transmission. It is a Flavivirus transmitted through arthropods belonging to the Aedes genus. Since 2015, ZIKV infections have increased dramatically; with 1.3 million people infected during 2015 in Brazil alone. This paper's objective is to highlight the conjectural epidemiological points of the virus' dissemination. The digital archives Pubmed, MEDLINE, EMBASE and Cochrane were searched for papers that assessed aspects of ZIKV transmission and epidemiology. The first isolation occurred in Uganda in 1947. Since then, important outbreaks were documented globally. Consequently, an emergent public health problem arose from a rapidly increasing incidence and its association with the development of neurological diseases such as microcephaly and Guillain-Barré syndrome. Key factors in the successful containment of outbreaks include surveillance of mosquitos in the neighbourhood, an early mosquito control treatment, an assertive information campaign, and the involvement of the local population and healthcare workers. As such, while ZIKV seems to be spreading globally in a similar manner to other arboviruses, such as Dengue and Chikungunya viruses, it can also be rapidly contained due to the pre-existing availability of necessary resources and regulatory tools as control measures. This review aims to provide a description of those characteristics of ZIKV infection that may be useful in the construction of effective outbreak control strategies.

Artificial reproduction of magnetic fields produced by a natural geomagnetic storm increases systolic blood pressure in rats.

The incidence of geomagnetic storms may be associated with changes in circulatory physiology. The way in which the natural variations of the geomagnetic field due to solar activity affects the blood pressure are poorly understood and require further study in controlled experimental designs in animal models. In the present study, we tested whether the systolic arterial pressure (AP) in adult rats is affected by simulated magnetic fields resembling the natural changes of a geomagnetic storm. We exposed adult rats to a linear magnetic profile that simulates the average changes associated to some well-known geomagnetic storm phases: the sudden commencement and principal phase. Magnetic stimulus was provided by a coil inductor and regulated by a microcontroller. The experiments were conducted in the electromagnetically isolated environment of a semi-anechoic chamber. After exposure, AP was determined with a non-invasive method through the pulse on the rat's tail. Animals were used as their own control. Our results indicate that there was no statistically significant effect in AP when the artificial profile was applied, neither in the sudden commencement nor in the principal phases. However, during the experimental period, a natural geomagnetic storm occurred, and we did observe statistically significant AP increase during the sudden commencement phase. Furthermore, when this storm phase was artificially replicated with a non-linear profile, we noticed a 7 to 9 % increase of the rats' AP in relation to a reference value. We suggested that the changes in the geomagnetic field associated with a geomagnetic storm in its first day could produce a measurable and reproducible physiological response in AP.

Assessment of microsatellites in estimating inter- and intraspecific variation among Neotropical Crocodylus species.

We tested microsatellites that were developed for the saltwater crocodile (Crocodylus porosus) for cross-species amplification and to provide an estimate of inter- and intraspecific variation among four species of Neotropical crocodiles (C. rhombifer, C. intermedius, C. acutus, and C. moreletii). Our results indicated that with the exception of 2 loci in C. intermedius, all 10 microsatellite loci were successfully amplified in the 4 species, producing a set of variably sized alleles that ranged in number between 2 and 14 alleles per locus. Similarly, private alleles (i.e., unique alleles) also were reported in all 4 species for at least 3 loci. The mean observed and expected heterozygosities (averaged across species for all 10 loci combined) ranged from 0.39 to 0.77 and from 0.44 to 0.78, respectively. In addition to this, we evaluated these microsatellites in 2 populations of C. acutus and C. moreletii to assess their utility in estimating intraspecific levels of polymorphisms. These microsatellites also showed considerable allelic variation in population level analysis. The set of 10 microsatellite loci in our study had the potential to be used as a tool in population and conservation genetic studies of Neotropical crocodiles.

Resonant photocurrent generation in dye-sensitized periodically nanostructured photoconductors by optical field confinement effects.

Herein we show experimental evidence of resonant photocurrent generation in dye-sensitized periodically nanostructured photoconductors, which is achieved by spectral matching of the sensitizer absorption band to different types of localized photon modes present in either periodic or broken symmetry structures. Results are explained in terms of the calculated spatial distribution of the electric field intensity within the configurations under analysis.

Dose and volume de-escalation of radiotherapy in head and neck cancer.

Radiotherapy plays a key role in the treatment of head and neck cancer. However, irradiation of the head and neck region is associated with high rates of acute and chronic toxicity. Technological advances have led to better visualisation of target volumes and critical structures and improved dose conformality in the treatment volume. Despite this, acute toxicity has not been substantially reduced and late toxicity has a significant impact on patients' quality of life. The greater radiosensitivity of tumours associated with the HPV and the development of new imaging techniques have encouraged research into new deintensified strategies to reduce the side effects of radiotherapy. The aim of this paper is to review the literature on the strategies of de-escalated treatment in dose and/or volume in head and neck cancer.

Cross reaction between proteins from Larrea divaricata Cav. (jarilla) and cellular and extracellular proteins of Pseudomonas aeruginosa.

Larrea divaricata is widely used in folk medicine to treat different pathologies, but little is known about its immunological properties. Pseudomonas aeruginosa is an opportunistic pathogen which causes several intrahospitalary infections. We aimed to assess the immunological relation between proteins from a crude extract of L. divaricata Cav. (JPCE) and cellular and extracellular proteins (EP) of P. aeruginosa, as well as to establish the cross reactivity between proteins of both species using a mouse anti-JPCE serum. Protein profiles of JPCE and P. aeruginosa were analyzed by SDS-PAGE. The percentage of similarity of protein bands between these two species was 43-57%. However, JPCE proteins were immunogenic. The reactivity of mouse anti-JPCE antibodies against different fractions was studied by western blot. The anti-JPCE serum detected several antigenic bands on different bacterial proteins. Several common immunoreactive bands were detected (27-100%) when bacterial proteins were incubated with anti-JPCE serum (heterologous reaction) and anti-bacterial proteins serum (homologous reaction). By enzyme-linked immunosorbant assay (ELISA) assays, high titers of anti-JPCE against different types of cellular bacterial fractions were observed (1/1280-1/2080). Our data clearly demonstrate that antibodies elicited with L. divaricata crude extract are able to cross-react with cellular and EP of P.aeruginosa. These findings could be relevant in the development of alternatives therapies for patients suffering intrahospitalary opportunistic infections with P.aeruginosa.

Clinical guide to perioperative management for videothoracoscopy lung resection (Section of Cardiac, Vascular and Thoracic Anesthesia, SEDAR; Spanish Society of Thoracic Surgery, SECT; Spanish Society of Physiotherapy).

The introduction of video-assisted thoracoscopic (VATS) techniques has led to a new approach in thoracic surgery. VATS is performed by inserting a thoracoscope through a small incisions in the chest wall, thus maximizing the preservation of muscle and tissue. Because of its low rate of morbidity and mortality, VATS is currently the technique of choice in most thoracic procedures. Lung resection by VATS reduces prolonged air leaks, arrhythmia, pneumonia, postoperative pain and inflammatory markers. This reduction in postoperative complications shortens hospital length of stay, and is particularly beneficial in high-risk patients with low tolerance to thoracotomy. Compared with conventional thoracotomy, the oncological results of VATS surgery are similar or even superior to those of open surgery. This aim of this multidisciplinary position statement produced by the thoracic surgery working group of the Spanish Society of Anesthesiology and Reanimation (SEDAR), the Spanish Society of Thoracic Surgery (SECT), and the Spanish Association of Physiotherapy (AEF) is to standardize and disseminate a series of perioperative anaesthesia management guidelines for patients undergoing VATS lung resection surgery. Each recommendation is based on an in-depth review of the available literature by the authors. In this document, the care of patients undergoing VATS surgery is organized in sections, starting with the surgical approach, and followed by the three pillars of anaesthesia management: preoperative, intraoperative, and postoperative anaesthesia.

Clinical guide to perioperative management for videothoracoscopy lung resection (Section of Cardiac, Vascular and Thoracic Anesthesia, SEDAR; Spanish Society of Thoracic Surgery, SECT; Spanish Society of Physiotherapy). / Guía clínica en el manejo perioperatorio para la cirugía de resección pulmonar por videotoracoscopia (Sección de Anestesia Cardiaca, Vascular y Torácica, SEDAR; Sociedad Española de Cirugía Torácica, SECT; Asociación Española de Fisioterapia, AEF).

The introduction of video-assisted thoracoscopic (VATS) techniques has led to a new approach in thoracic surgery. VATS is performed by inserting a thoracoscope through a small incisions in the chest wall, thus maximizing the preservation of muscle and tissue. Because of its low rate of morbidity and mortality, VATS is currently the technique of choice in most thoracic procedures. Lung resection by VATS reduces prolonged air leaks, arrhythmia, pneumonia, postoperative pain and inflammatory markers. This reduction in postoperative complications shortens hospital length of stay, and is particularly beneficial in high-risk patients with low tolerance to thoracotomy. Compared with conventional thoracotomy, the oncological results of VATS surgery are similar or even superior to those of open surgery. This aim of this multidisciplinary position statement produced by the thoracic surgery working group of the Spanish Society of Anesthesiology and Reanimation (SEDAR), the Spanish Society of Thoracic Surgery (SECT), and the Spanish Association of Physiotherapy (AEF) is to standardize and disseminate a series of perioperative anaesthesia management guidelines for patients undergoing VATS lung resection surgery. Each recommendation is based on an in-depth review of the available literature by the authors. In this document, the care of patients undergoing VATS surgery is organized in sections, starting with the surgical approach, and followed by the three pillars of anaesthesia management: preoperative, intraoperative, and postoperative anaesthesia.

Comparison of higher order aberrations in amblyopic and non-amblyopic eyes in pediatric patients with anisometropic amblyopia.

Purpose: To compare the ocular higher order aberrations (HOAs) for the physiologic pupil size in amblyopic and non-amblyopic eyes of patients with anisometropic amblyopia in pediatric age group. Methods: Children between 5 and 15 years age having treatment naïve anisometropic amblyopia; after a detailed examination by a pediatric ophthalmologist; underwent assessment of wavefront aberrations for both amblyopic and non-amblyopic eyes at their physiologic pupil sizes using i-Trace ray tracing wavefront aberrometer. The axial lengths were also measured using IOL Master 500. The RMS values of the total ocular higher order aberrations (HOAs) and those arising from internal and corneal components of the two eyes were tabulated and compared to look for differences. Comparison of total ocular aberrations for pre-determined refractive error groups was also done for amblyopic and non-amblyopic eyes separately. Results: Eighty-eight eyes of 44 subjects were included for analysis. Mean pupil size was comparable in between amblyopic and non-amblyopic eyes (3.98 mm vs. 4.07 mm, P = 0.346). The mean axial lengths of the two eyes were comparable (amblyopic eyes 23.13 mm vs. non-amblyopic eyes 22.88 mm, P = 0.419). Significant differences in total HOAs and those arising from the internal optics (except spherical aberrations) of the eye were noted between the two eyes. There were no differences in the corneal HOAs. The total HOAs were comparable amongst the various refractive error groups for amblyopic and non-amblyopic eyes individually. Conclusion: There are significant differences in ocular HOAs between amblyopic and non-amblyopic eyes in children with anisometropic amblyopia.

Decreased food anticipatory activity of obese mice relates to hypothalamic c-Fos expression.

During daily Food Restriction (FR), obese Neotomodon alstoni mice present decreased Food Anticipatory Activity (FAA) compared to lean mice. Here, we investigated whether FOS expression in hypothalamic nuclei involved in food synchronization and anticipation parallels decreased FAA during daily FR of obese N. alstoni. Locomotor activity of lean and obese mice in ad libitum feeding conditions was monitored for at least two weeks. Then, a gradual restriction of food access was followed to establish a 5h period of daily food access. FR was maintained during at least two weeks before sacrifice of mice at the starting point of the feeding period. Obese mice subjected to FR displayed an overall reduction of FOS-positive (FOS+) hypothalamic neurons, while lean mice in a similar protocol exhibited an increase in FOS+ neurons within the arcuate and dorsomedial hypothalamic nuclei. These results are consistent with decreased FAA displayed by obese mice in comparison to lean mice. Furthermore, limbic system areas of lean mice, such as the cingulate cortex and the hippocampus, showed an increase in FOS during FR, while no responses were observed in obese mice. The daily food intake of obese mice was severely reduced during FR, compared to the ad libitum condition, whereas food intake in lean mice was not affected by FR. Current data suggests that decreased hypothalamic and limbic neuronal activation may contribute to the reduction of FAA in obese N. alstoni mice.

Impact of damming on the Chironomidae of the upper zone of a tropical run-of-the-river reservoir.

We examined the effects of the Mogi-Guaçu river damming (São Paulo State, Brazil) on the Chironomidae fauna. Pre, during, and post-filling sampling was carried out in the main channel and margins of one site in the upper zone of the reservoir, using a modified Petersen grab (325 cm2). We evaluated the total, subfamily, and tribe densities and also their relative abundance. Analysis of genera included densities, relative abundance, richness, and dominance. The Rosso's ecological value index (EVI) determined the ecological importance of each genus. There was a tendency of decrease of the total Chironomidae density, increase in the percentage of Chironomini, and decrease in densities and percentages of Orthocladiinae and Tanytarsini. These changes in percentage were respectively related to Polypedilum, Lopescladius, and Rheotanytarsus, the genera with the highest EVI values. After-filling richness was lower in the margins and dominance of genera did not change significantly. Chironomidae in the margins was more sensitive to damming than in the main channel. This difference in sensibility sustains the use of Chironomidae as bioindicators. Damming impact was indicated by the reduction of both genera richness in the margins and relative abundance of groups typical of faster waters. The results have highlighted the need for multi-habitat analysis combined with a before-after sampling approach in the environmental impact studies concerning the damming impact on the benthic fauna.

A forced five-dimensional factor analysis and concurrent validity of the Positive and Negative Syndrome Scale in Mexican schizophrenic patients.

UNLABELLED: The heterogeneity of schizophrenic symptomatology is well documented. The positive-negative distinction is limited to cover the entire spectrum of schizophrenic psychopathology in order to describe the various clinical aspects of the disorder. METHOD: We recruited 150 schizophrenic patients between May 2002 and September 2003. Diagnoses were based on a structured clinical interview. The Positive and Negative Syndrome Scale (PANSS) was used to evaluate general psychopathology and symptom severity. For the concurrent validity of the pentagonal model of the PANSS, the BPRS, the CDSS, the OAS and the MMSE were used. RESULTS: The forced five-factor principal-component analysis explained 53.4% of the total variance. There were significant correlations between the clinical rating scales and the five components of the PANSS. DISCUSSION: Our data support a pentagonal model underlying the multidimensional schizophrenic symptomatology as assessed by the PANSS. The five-factor structure of the PANSS in Mexican schizophrenic patients enables further elucidation of the various clinical aspects of schizophrenia.

Circadian rhythm of ERG in Iguana iguana: role of the pineal.

In green iguanas, the pineal controls the circadian rhythm of body temperature but not the rhythm of locomotor activity. As part of a program to investigate the characteristics of this multioscillator circadian system, the authors studied the circadian rhythms of the electroretinographic response (ERG) and asked whether the pineal gland is necessary for the expression of this rhythm. ERGs from a total of 24 anesthetized juvenile iguanas were recorded under four different conditions: (a) complete darkness (DD), (b) dim light-dark cycles (dLD), (c) constant dim light (dLL), and (d) pinealectomized in DD. Results demonstrate that the b-wave component of the ERG shows a very clear circadian rhythm in DD and that this rhythm persists in dLL and entrains to dLD cycles. The ERG response is maximally sensitive during the subjective day. Pinealectomy does not abolish the circadian rhythm in ERG, demonstrating that the oscillator responsible for the ERG rhythm is located elsewhere.

Environmental Effects on the Photophysics of Organic-Inorganic Halide Perovskites.

The photophysical properties of films of organic-inorganic lead halide perovskites under different ambient conditions are herein reported. We demonstrate that their luminescent properties are determined by the interplay between photoinduced activation and darkening processes, which strongly depend on the atmosphere surrounding the samples. We have isolated oxygen and moisture as the key elements in each process, activation and darkening, both of which involve the interaction with photogenerated carriers. These findings show that environmental factors play a key role in the performance of lead halide perovskites as efficient luminescent materials.

A new Bayesian network-based approach to the analysis of sperm motility: application in the study of tench (Tinca tinca) semen.

In this study a Bayesian network (BN) has been built for the study of the objective motility of Tinca tinca spermatozoa (spz). Semen from eight 2-year-old sexually mature male tenchs was obtained and motility analyses were performed at 6-17, 23-34 and 40-51 s after activation, using computer-assisted sperm analysis (CASA) software. Motility parameters rendered by CASA were treated with a two-step cluster analysis. Three well-defined sperm subpopulations were identified, varying the proportion of spermatozoa contained in each cluster with time and male. Cluster, cinematic and time variables were used to build the BN to study the probabilistic relationships among variables and how each variable influenced the final sperm classification into one of three predefined clusters. Both network structure and conditional probabilities were calculated based on the collected data set. Results shown that almost all the variables were directly or indirectly related to each other. By doing probabilistic inference we observed that the cluster distribution corresponded to the definition provided by the cluster analysis. Also, velocity and time variables determined the cluster to which each spermatozoon belonged with a high degree of accuracy. Thus, BNs can be applied in the study of sperm motility. The construction of a BN that include fertility data opens a new way to try to clarify the roles of motility and other sperm quality indicators in fertilization.

Premorbid adjustment and violent behavior in schizophrenic patients.

UNLABELLED: We examined the influence of premorbid adjustment on violent behavior in schizophrenic patients. There is some evidence that poor premorbid adjustment predicts violent behavior, then we decided to examine this hypothesis further. METHOD: We recruited 72 schizophrenic patients without concomitant substance abuse 6 months prior to the assessment. Diagnoses were based on the SCID-I. Premorbid adjustment was evaluated with the Premorbid Adjustment Scale and violent behaviors with the Overt Aggression Scale. RESULTS: Violent schizophrenic patients showed an overall worse premorbid adjustment during childhood. In addition, the area of "peer relationships" was significantly diminished in several life period sections such as childhood, early and late adolescence in violent patients. DISCUSSION: Our data indicate that difficulties in social relationships during early stages of life may increase the risk of future violent behavior among schizophrenic patients.

Sugar uptake and involved enzymatic activities by yeasts and lactic acid bacteria: their relationship with breadmaking quality.

The uptake kinetics of sugars present in wheat doughs and alpha-glucosidase as well as beta-fructosidase activities were determined in different strains of yeasts and lactic acid bacteria. These strains were previously selected according to their breadmaking quality. Saccharomyces cerevisiae (P6), Candida guilliermondii (P40), Lactobacillus plantarum (B31 and La18) and L. brevis (B21) showed good performance, while Sacch. fructuum (P43), L. cellobiosus (B37) and Enterococcus faecium (B11) yielded bread of lower quality. Leuconostoc mesenteroides (B10), when used in combination with other strains led also to high quality starters. All yeast strains used assimilated glucose, fructose and maltose, exhibiting saturable kinetics. Lactic acid bacteria showed saturable kinetics only for hexoses, whereas disaccharide uptake was linear. Sacch. cerevisiae, Leuconostoc mesenteroides, L. brevis and L. plantarum (B31) displayed better sugar uptake properties. For all the strains used alpha-glucosidase and beta-fructosidase activities were detected. The highest specific activities were found for Sacch. cerevisiae, C. guilliermondii and L. plantarum (B31). These results indicate good correlation between the parameters evaluated and the breadmaking potential of the microorganisms.