Impact of stereotactic body radiation therapy on geriatric assessment and management for older patients with head and neck cancer using G8

PurposeManagement of head and neck cancers (HNC) in older adults is a common but challenging clinical scenario. We assess the impact of Stereotactic Body Radiation Therapy (SBRT) on survival utilizing the Geriatric-8 (G8) questionnaire.Materials and methods171 HNC patients, deemed medically unfit for definitive treatment, were treated with SBRT ± systemic therapy. G8 questionnaires were collected at baseline, at 4–6 weeks, and at 2–3 months post-treatment. Patients were stratified according to their baseline G8 score: <11 as ‘vulnerable’, 11–14 as ‘intermediate’, and >14 as ‘fit’. Overall survival (OS) was assessed through univariate Kaplan Meier analysis. Repeated measures ANOVA was used to determine if baseline characteristics affected G8 score changes.ResultsMedian follow-up was seventeen months. 60% of patients presented with recurrent HNC, 30% with untreated HNC primaries, and 10% with metastatic non-HNC primaries. Median age was 75 years. Median Charlson Comorbidity Index score was 2. 51% of patients were ‘vulnerable’, 37% were ‘intermediate’, and 12% were ‘fit' at baseline, with median survival of 13.2, 24.3, and 41.0 months, respectively (p = .004). Patients who saw a decrease in their follow-up G8 score (n = 69) had significantly lower survival than patients who had stable or increased follow-up G8 scores (n = 102), with median survival of 8.6 vs 36.0 months (p < .001).ConclusionThe G8 questionnaire may be a useful tool in upfront treatment decision-making to predict prognosis and prevent older patients from receiving inappropriate anti-cancer treatment. Decline in follow-up G8 scores may also predict worse survival and aid in goals of care following treatment.     

脑膜瘤生物学特性的研究——流式细胞计对脑膜瘤DNA含量的分析及其生物学行为的相关研究

为了定量测试脑膜瘤WHO分级法的价值,作者应用倍体分类、增殖指数和S期细胞比率三项参数进行分析,发现这三项指标与WHO分级密切相关。脑膜瘤异形细胞、坏死、核分裂及脑浸润的出现与肿瘤WHO分级增加和肿瘤复发密切相关。这些结果特别对肿瘤的异质性和测量技术差异问题给予小心评价。     

Electroencephalography in acute head injury

The established uses of standard and computerized EEG in acute head injury are outlined. Emphasis is placed on EEG correlation with level of consciousness, rostrocaudal deterioration, brainstem lesions, and prognosis. The utility of the standard EEG in seizures and toxic metabolic states accompanying severe head injury is also discussed.     

Evoked potentials in head injury and states of increased intracranial pressure

Recent clinical studies have addressed the utility of sensory evoked potentials (auditory, somatosensory, and visual) in head injury. The clinical significance of evoked potentials in head trauma, states of increased intracranial pressure, and post-traumatic syndrome is discussed. Emphasis is placed on up-to-date studies discussing evoked potential correlation with clinical findings, lesion localization, intracranial pressure, brain herniation, and prognosis.     

SARS-CoV-2 Genetic Diversity and Lineage Dynamics in Egypt during the First 18 Months of the Pandemic

COVID-19 was first diagnosed in Egypt on 14 February 2020. By the end of November 2021, over 333,840 cases and 18,832 deaths had been reported. As part of the national genomic surveillance, 1027 SARS-CoV-2 near whole-genomes were generated and published by the end of July 2021. Here we describe the genomic epidemiology of SARS-CoV-2 in Egypt over this period using a subset of 976 high-quality Egyptian genomes analyzed together with a representative set of global sequences within a phylogenetic framework. A single lineage, C.36, introduced early in the pandemic was responsible for most of the cases in Egypt. Furthermore, to remain dominant in the face of mounting immunity from previous infections and vaccinations, this lineage acquired several mutations known to confer an adaptive advantage. These results highlight the value of continuous genomic surveillance in regions where VOCs are not predominant and the need for enforcement of public health measures to prevent expansion of the existing lineages.     

Microstructural Evolution,Tensile Failure,Fatigue Behavior and Wear Properties of Al2O3 Reinforced Al2014 Alloy T6 Heat Treated Metal Composites

The paper focused on an experimental study on the microstructural, mechanical, and wear characteristics of 15 wt.% alumina (Al₂O₃) particulates with an average particle size of 20 µm, reinforced in Al2014 alloy matrix composite as-cast and heat-treated samples. The metal matrix composite (MMC)samples were produced via a novel two-stage stir-casting technique. The fabricated composite samples were subjected to evaluate hardness, tensile strength, fatigue behavior and wear properties for both as cast and T6 heat-treated test samples. The Al2014 alloy and Al2014-15 wt.% Al₂O₃ MMCs were in solution for 1 h at a temperature of 525 °C, quenched instantly in cold water, and then artificially aged for 10 h at a temperature of 175 °C. SEM and X-ray diffraction analyses were used to investigate the microstructure and dispersion of the reinforced Al₂O₃ particles in the composite and the base alloy Al2014. The obtained results indicated that the hardness, tensile and fatigue strength and wear resistance increased when an amount of Al₂O₃ particles was added, compared to the as-cast Al2014 alloy and it was observed that after subjecting the same composite samples to heat treatment, there was further enhancement in the mechanical and wear properties in the Al2014 matrix alloy and Al2014-15 wt.% Al₂O₃ composite samples.