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8 million euros/trimester in costs. Finally, the decrease in hospitalizations did not disproportionally affect patients based on their gender, age, or origin, although it fostered a reduction in readmissions.
The management of solitary locoregional recurrence (sLRR) of head and neck squamous cell carcinoma (HNSCC) previously treated with radiotherapy (RT) is challenging. We aimed to identify characteristics associated with improved outcome.
We identified patients treated with non-sinus, mucosal HNSCC who initially received IMRT. We characterized overall survival (OS) and locoregional control (LRC). Multivariable analysis (MVA) on survival and patterns-of-failure were performed using Cox and Fine-Gray competing risks analysis.
We identified 90 patients with available follow-up. In total, 67 (74%) patients received curative-intent salvage, while 23 (26%) received palliative care. On MVA, significantly improved OS and LRC were associated with lower initial N-classification and use of salvage total laryngectomy (TL) or neck dissection (ND).
A nontrivial number of patients with sLRR cannot undergo salvage. Among patients treated with curative intent, TL or ND were clearly associated with improved OS and LRC.
A nontrivial number of patients with sLRR cannot undergo salvage. Among patients treated with curative intent, TL or ND were clearly associated with improved OS and LRC.A key policy question is whether continued expansion of university education is beneficial for the marginally eligible student. In this paper we exploit an arbitrary university eligibility rule combined with regression discontinuity design to estimate the causal effect of university attendance on healthcare utilization amongst young adults in Sweden. We find that the eligibility rule leads to a clear jump in university attendance of between 10% and 14% points for both males and females. 2SLS estimates find that a 10% point increase in university attendance causes a roughly one percentage point increase in hospital admissions due to mental ill health for males, almost exclusively related to alcohol and narcotics. Our findings for females, however, imply the opposite, suggesting that university attendance decreases hospital admissions related to mental health. The results for males sit in contrast to results from previous studies, and suggest that the effect of university education on health for the male student at the margin of eligibility is different to that of the average student.Recent advances in both genomics and ecological modelling present new, multidisciplinary opportunities for resolving species boundaries and understanding the mechanisms that maintain their integrity in regions of contact. Here, we use a combination of high-throughput DNA sequencing and ecological niche modelling to resolve species boundaries and niche divergence within the Speyeria atlantis-hesperis (Lepidoptera Nymphalidae) complex, a confusing group of North American butterflies. This complex is notorious for its muddled species delimitations, morphological ambiguity, and extensive mitonuclear discordance. Our admixture and multispecies coalescent-based analyses of single nucleotide polymorphisms identified substantial divergences between S. atlantis and S. hesperis in areas of contact, as well as between distinct northern and southern lineages within S. hesperis. Our results also provide evidence of past introgression relating to another species, S. zerene, which previous work has shown to be more distantly related to the S. atlantis-hesperis complex. We then used ecological models to predict habitat suitability for each of the three recovered genomic lineages in the S. atlantis-hesperis complex and assessed their pairwise niche divergence. These analyses resolved that these three lineages are significantly diverged in their respective niches and are not separated by discontinuities in suitable habitat that might present barriers to gene flow. We therefore infer that ecologically-mediated selection resulting in disparate habitat associations is a principal mechanism reinforcing their genomic integrity. Overall, our results unambiguously support significant evolutionary and ecological divergence between the northern and southern lineages of S. hesperis, sufficient to recognize the southern evolutionary lineage as a distinct species, called S. nausicaa based on taxonomic priority.
Rhinoviruses are the major precipitant of asthma exacerbations and individuals with asthma experience more severe/prolonged rhinovirus infections. Concurrent viral infection and allergen exposure synergistically increase exacerbation risk. Although dendritic cells orchestrate immune responses to both virus and allergen, little is known about their role in viral asthma exacerbations.
To characterize dendritic cell populations present in the lower airways, and to assess whether their numbers are altered in asthma compared to healthy subjects prior to infection and during rhinovirus-16 infection.
Moderately-severe atopic asthmatic patients and healthy controls were experimentally infected with rhinovirus-16. Bronchoalveolar lavage was collected at baseline, day 3 and day 8 post infection and dendritic cells isolated using fluorescence activated cell sorting.
Numbers of type I conventional dendritic cells, which cross prime CD8
T helper cells and produce innate interferons, were significantly reduced iniral infection observed in asthma patients.
To evaluate the clinical significance of tumor response to induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (LANPC) patients and further to develop a nomogram for predicting survival prognosis.
A total of 498 patients with stage III-IVA NPC applying IC and concurrent chemotherapy were reviewed (training cohort, n=376; validation cohort, n=122).
Tumor response was an independent predictor for clinical outcomes. The nomogram included age, N stage, pretreatment Epstein-Barr virus DNA, lymphocyte-to-monocyte ratio, and tumor response achieved an ideal C-index of 0.703 (95% CI 0.655-0.751) in the validation cohort for predicting overall survival (OS), which outperformed than that of the TNM system alone (C-index, 0.670, 95% CI 0.622-0.718). In addition, the nomogram could successfully classified patients into different risk groups.
We established and validated a precise and convenient nomogram based on tumor response for predicting the OS of LANPC patients.
We established and validated a precise and convenient nomogram based on tumor response for predicting the OS of LANPC patients.In conservation, trust and justice are increasingly recognized as both intrinsically valuable and critical for successful socio-ecological outcomes. However, the interdependence between these concepts has not been explored. In reviewing the conservation trust scholarship, we find efforts to build trust between conservation and local actors, yet this is often conceived to incentivize local cooperation within dominant paradigms. We argue that trust-building which does not actively plan to address power asymmetries in conservation practice may inadvertently re-embed inequities, and therefore offer a justice-trust model to provide a critical analysis of conservation partnerships. We draw on environmental justice theory to better calibrate trust literature for the historical-political settings of conservation, especially in the Global South. We demonstrate that justice and trust share strong theoretical links with important practical implications for understanding relationships. We apply our justice-trust framework to multiple case-studies, exploring i) how perceptions of (in)justice can shape willingness to trust, and ii) the ways in which nature-dependent communities and marginalized conservation workers are trusted, or the conditions they give trust under, can lead to partnerships being perceived as (un)just. selleck We argue that focusing on trust in tandem with justice can help identify power dynamics so they can be more readily addressed. This article is protected by copyright. All rights reserved.The oxygen evolution reaction (OER) is a critical element for all sorts of reactions that use water as a hydrogen source, such as hydrogen evolution and electrochemical CO2 reduction, and novel design principles that provide highly active sites on OER electrocatalysts push the limits of their practical applications. Herein, Au-cluster loading on unilamellar exfoliated layered double hydroxide (ULDH) electrocatalysts for the OER is demonstrated to fabricate a heterointerface between Au clusters and ULDHs as an active site, which is accompanied by the oxidation state modulation of the active site and interfacial direct OO coupling ("interfacial DOOC"). The Au-cluster-loaded ULDHs exhibit excellent activities for the OER with an overpotential of 189 mV at 10 mA cm-2 . X-ray absorption fine structure measurements reveal that charge transfer from the Au clusters to ULDHs modifies the oxidation states of trivalent metal ions, which can be active sites on the ULDHs. The present study, supported by highly sensitive spectroscopy combining reflection absorption infrared spectroscopy and modulation-excitation spectroscopy and density functional theory calculations, indicates that active sites at the interface between the Au clusters and ULDHs promote a novel OER mechanism through interfacial DOOC, thereby achieving outstanding catalytic performance.
Although coronavirus disease 2019 (COVID-19) is primarily a respiratory infection, mounting evidence suggests that the gastrointestinal tract is involved in the disease, with gut barrier dysfunction and gut microbiota alterations being related to disease severity. Whether these alterations persist and are related to long-term respiratory dysfunction remains unknown.
Plasma was collected during hospital admission and after 3 months from the NOR-Solidarity trial (n = 181) and analyzed for markers of gut barrier dysfunction and inflammation. At the 3-month follow-up, pulmonary function was assessed by measuring the diffusing capacity of the lungs for carbon monoxide (DL
). Rectal swabs for gut microbiota analyses were collected (n = 97) and analyzed by sequencing the 16S rRNA gene.
Gut microbiota diversity was reduced in COVID-19 patients with respiratory dysfunction, defined as DL
below the lower limit of normal 3 months after hospitalization. These patients also had an altered global gut microbiota cung axis that should be further investigated in relation to long-term pulmonary dysfunction and long COVID.
While much literature has examined the independent effect of perceived neighbourhood disorder on criminal behaviour and/or mental disorder, comparatively little is known about the role of depressive symptoms on these associations over time.
Our aim was to examine whether depressive symptoms mediate association between perceived neighbourhood disorder, future criminal justice contact, and future suicidal ideation.
We grounded this research in primary arguments derived from General Strain Theory (GST). Data were drawn from structured self-reports in surveys of over 2000 young adult participants from the Children of the National Longitudinal Survey of Youth, who are the offspring born to the women from the National Longitudinal Survey of Youth 1979. Information on neighbourhood disorder and depressive symptoms were used from the 2012 data collection period, while information on criminal justice contact and suicidal ideation were drawn from the 2014 period. Structural equation modelling was used to examine both direct and indirect pathways between neighbourhood disorder, depression, contact with the justice system, and suicidal ideation from 2012 to 2014.
