Lung cancer: risk factors, management, and prognosis

Lung cancer or lung tumor the most common cause of cancer death in men and second most common in women after breast cancer. Highest rates in North America, Europe, and East Asia, with one third of new cases in China, lower rates in Africa and South Asia. Worldwide in 2012 lung cancer resulted in 1.6 million deaths. Risk factors include smoking, exposure to radon gas, asbestos, second-hand smoke, air pollution, and geneticfactors. Pathogenesis is similar to other cancers, by activation of oncogenes or inactivation of tumor suppressor genes. Two main types of lung cancer are small-cell lung carcinoma(SCLC),and non-small-cell lung carcinoma(NSCLC) Clinical manifestation include coughing, coughing blood, weight loss, weakness, fever or clubbing of the fingernails, hypercalcemia, myasthenia syndrome (muscle weakness), and metastases. Metastatic disease includes weight loss, bone pain and neurological symptoms. Diagnosis mainly by chest radiographs and computed tomography (CT) scans. Lung cancers are classified according to histological type, staging uses TNM (tumor, lymph node and metastases) system. Management depends on cancer specific type, by surgery, radiotherapy and chemotherapy. In the U.S 16.8% survive for at least five years, in England overall five year survival less than 10%.Prevention, cessation of smoking, screening for lung cancer for those long smoking history and between 55 and 80 years. Long term intake of vitamin A,vitamin vitamin D, or vitamin E does not reduce risk of lung cancer. Higher intake of vegetables and fruit tend to lower risk. There is no clear association between diet and lung cancer

Sistim gotong royong dalam masyarakat pedesaan Propinsi Daerah Istimewa Aceh

Sistem gotong-royong merupakan suatu hal yang bertambah penting, apalagi kalau diingat bahwa generasi muda Indonesia nanti akan mengetahui bagaimana mereka dari generasi yang lalu mengembangkan dan membina nilai-nilai luhur yang terpancar dari unsur budaya mereka. Buku ini memuat berbagai informasi yang tumbuh dan berkembang dalam masyarakat tempo dulu mengenai sistim gotong royong dalam masyarakat pedesaan Propinsi Daerah Istimewa Aceh

Screening for coping style increases the power of gene expression studies

Background: Individuals of many vertebrate species show different stress coping styles and these have a striking influence on how gene expression shifts in response to a variety of challenges. Principal Findings: This is clearly illustrated by a study in which common carp displaying behavioural predictors of different coping styles (characterised by a proactive, adrenaline-based or a reactive, cortisol-based response) were subjected to inflammatory challenge and specific gene transcripts measured in individual brains. Proactive and reactive fish differed in baseline gene expression and also showed diametrically opposite responses to the challenge for 80% of the genes investigated. Significance: Incorporating coping style as an explanatory variable can account for some the unexplained variation that is common in gene expression studies, can uncover important effects that would otherwise have passed unnoticed and greatly enhances the interpretive value of gene expression data

PERT: A Method for Expression Deconvolution of Human Blood Samples from Varied Microenvironmental and Developmental Conditions

The cellular composition of heterogeneous samples can be predicted using an expression deconvolution algorithm to decompose their gene expression profiles based on pre-defined, reference gene expression profiles of the constituent populations in these samples. However, the expression profiles of the actual constituent populations are often perturbed from those of the reference profiles due to gene expression changes in cells associated with microenvironmental or developmental effects. Existing deconvolution algorithms do not account for these changes and give incorrect results when benchmarked against those measured by well-established flow cytometry, even after batch correction was applied. We introduce PERT, a new probabilistic expression deconvolution method that detects and accounts for a shared, multiplicative perturbation in the reference profiles when performing expression deconvolution. We applied PERT and three other state-of-the-art expression deconvolution methods to predict cell frequencies within heterogeneous human blood samples that were collected under several conditions (uncultured mono-nucleated and lineage-depleted cells, and culture-derived lineage-depleted cells). Only PERT's predicted proportions of the constituent populations matched those assigned by flow cytometry. Genes associated with cell cycle processes were highly enriched among those with the largest predicted expression changes between the cultured and uncultured conditions. We anticipate that PERT will be widely applicable to expression deconvolution strategies that use profiles from reference populations that vary from the corresponding constituent populations in cellular state but not cellular phenotypic identity

Systematic review of reduced therapy regimens for children with low risk febrile neutropenia

PURPOSE: Reduced intensity therapy for children with low-risk febrile neutropenia may provide benefits to both patients and the health service. We have explored the safety of these regimens and the effect of timing of discharge. METHODS: Multiple electronic databases, conference abstracts and reference lists were searched. Randomised controlled trials (RCT) and prospective observational cohorts examining the location of therapy and/or the route of administration of antibiotics in people younger than 18 years who developed low-risk febrile neutropenia following treatment for cancer were included. Meta-analysis using a random effects model was conducted. I (2) assessed statistical heterogeneity not due to chance. Registration: PROSPERO (CRD42014005817). RESULTS: Thirty-seven studies involving 3205 episodes of febrile neutropenia were included; 13 RCTs and 24 prospective observational cohorts. Four safety events (two deaths, two intensive care admissions) occurred. In the RCTs, the odds ratio for treatment failure (persistence, worsening or recurrence of fever/infecting organisms, antibiotic modification, new infections, re-admission, admission to critical care or death) with outpatient treatment was 0.98 (95% confidence interval (95%CI) 0.44-2.19, I (2) = 0 %) and with oral treatment was 1.05 (95%CI 0.74-1.48, I (2) = 0 %). The estimated risk of failure using outpatient therapy from all prospective data pooled was 11.2 % (95%CI 9.7-12.8 %, I (2) = 77.2 %) and using oral antibiotics was 10.5 % (95%CI 8.9-12.3 %, I (2) = 78.3 %). The risk of failure was higher when reduced intensity therapies were used immediately after assessment, with lower rates when these were introduced after 48 hours. CONCLUSIONS: Reduced intensity therapy for specified groups is safe with low rates of treatment failure. Services should consider how these can be acceptably implemented

Shallot Peel (Allium cepa L.) Snack Bar as Immunomodulator for Health Improvement in the Digital Era

The digital era has brought many changes, both positive and negative impacts. The challenges of this digital era cover various sectors, including the health sector. One of the effects is the radiation from electromagnetic waves due to the use of cell phones that can interfere with health in the long term, such as a decrease in the immune system. This study aims to determine the secondary metabolite content of shallot peel extract and the formulation of the snack bar as a nutraceutical product with antioxidant properties. It becomes a solution to increase the immune system or immunomodulator. An evidenced by the phytochemical screening test, which gave positive results. In addition, this snack bar also positively contains essential nutrients, such as carbohydrates, protein, and fat. From the hedonic test, the snack bar formulation has the appearance of a snack bar in general, with solid consistency and brownish-yellow color, a characteristic odor of wheat, and a savory taste with a small amount of sweetness. This snack bar formulation has the potential as an immunomodulator against the decline in the immune system. The tastes of the snack bar are acceptable to the public

Hepatocellular carcinoma in Pakistan: where do we stand?

Context: From the 1970s till the mid 1990s, hepatitis B was the most common etiological factor for hepatocellular carcinoma (HCC) in Pakistan. Afterwards, a shift in HCC etiology was observed with a steady rise in hepatitis C virus (HCV) related HCC cases. HCV-3a, which is the most prevalent genotype, is also most frequent in HCV related HCC. There was an increase in the proportion of non-B non-C (NBNC) HCC cases as well, which might be attributed to an increase in non-alcoholic fatty liver disease. Evidence Acquisition: The age-standardized rate for HCC is 7.64/100 000 in males and 2.8/100 000 in females. Male to female ratio is 3.6:1. Usual age of presentation is in the fifth and sixth decade. Most patients present with advanced disease, as they are not in a regular surveillance program. This is more so for patients with NBNC chronic liver disease. As many sonologists in Pakistan are practicing without sufficient training to pick up early lesions, alpha-fetoprotein is still recommended to compliment ultrasound in the surveillance of HCC. Results: Majority of HCC patients present with nonresectable disease. Interventions such as transarterial chemoembolization, radiofrequency ablation, resection and chemotherapy including sorafenib are available in selected centers. Pakistan appears to be in an area of intermediate endemicity for HCC. There is a need for population based epidemiological studies to estimate the exact disease burden. Conclusions: Measures to prevent the spread of hepatitis C and B can slow down the epidemic rise in the incidence of HCC in the coming decades. There is a need to implement a proper surveillance program to identify HCC cases at an early stage

Overview of biologically digested leachate treatment using adsorption

Biological process is effective in treating most biodegradable organic matter present in leachate; however, a significant amount of ammonia, metals and refractory organic compounds may still remain in this biologically digested leachate. This effluent cannot be released to receiving bodies until the discharge limit is met. Several physical/chemical processes have been practiced as post-treatment to remove the remaining pollutants including coagulation–flocculation, oxidation and adsorption. Adsorption is often applied in leachate treatment as it enhances removal of refractory organic compounds. This chapter will focus on works related to adsorption as one of the commonly used methods to treat biologically digested leachate further down to acceptable discharge limit

Overview of biologically digested leachate treatment using adsorption

Biological process is effective in treating most biodegradable organic matter present in leachate; however, a significant amount of ammonia, metals and refractory organic compounds may still remain in this biologically digested leachate. This effluent cannot be released to receiving bodies until the discharge limit is met. Several physical/chemical processes have been practiced as post-treatment to remove the remaining pollutants including coagulation–flocculation, oxidation and adsorption. Adsorption is often applied in leachate treatment as it enhances removal of refractory organic compounds. This chapter will focus on works related to adsorption as one of the commonly used methods to treat biologically digested leachate further down to acceptable discharge limit

Pharmacological development of target-specific delocalized lipophilic cation-functionalized carboranes for cancer therapy

PURPOSE: Tumor cell heterogeneity and microenvironment represent major hindering factors in the clinical setting toward achieving the desired selectivity and specificity to malignant tissues for molecularly targeted cancer therapeutics. In this study, the cellular and molecular evaluation of several delocalized lipophilic cation (DLC)-functionalized carborane compounds as innovative anticancer agents is presented. METHODS: The anticancer potential assessment of the DLC-carboranes was performed in established normal (MRC-5, Vero), cancer (U-87 MG, HSC-3) and primary glioblastoma cancer stem (EGFRpos, EGFRneg) cultures. Moreover, the molecular mechanism of action underlying their pharmacological response is also analyzed. RESULTS: The pharmacological anticancer profile of DLC-functionalized carboranes is characterized by: a) a marked in vitro selectivity, due to lower concentration range needed (ca. 10 fold) to exert their cell growth-arrest effect on U-87 MG and HSC-3, as compared with that on MRC-5 and Vero; b) a similar selective growth inhibition behavior towards EGFRpos and EGFRneg cultures (>10 fold difference in potency) without, however, the activation of apoptosis in cultures; c) notably, in marked contrast to cancer cells, normal cells are capable of recapitulating their full proliferation potential following exposure to DLC-carboranes; and, d) such pharmacological effects of DLC-carboranes has been unveiled to be elicited at the molecular level through activation of the p53/p21 axis. CONCLUSIONS: Overall, the data presented in this work indicates the potential of the DLC-functionalized carboranes to act as new selective anticancer therapeutics that may be used autonomously or in therapies involving radiation with thermal neutrons. Importantly, such bifunctional capacity may be beneficial in cancer therapy