Notes

Checking regarding serum lactate amount through cardiopulmonary resuscitation throughout grownup in-hospital stroke.
Co-culture of γδT cells with CD8 T cells in presence of hypoxia showed that PDL1high γδT cells brought about apoptosis of PD1high CD8 Tcells which could be significantly reversed upon blocking PD1. Thus, future immunotherapeutic treatment modality for oral cancer may use a combined approach of blocking the PD-1/PDL1 signaling and targeting HIF1α which may help in reversing hypoxia-induced immunosuppression. This article is protected by copyright. All rights reserved.Objectives Shift work may be associated with an increased incidence of respiratory infections. However, underlying mechanisms are unclear. Therefore, our aim was to examine the mediating role of sleep, physical activity, and diet in the association between shift work and respiratory infections. Methods This prospective cohort study included 396 shift and non-shift workers employed in hospitals. At baseline, sleep duration and physical activity were measured using actigraphy and sleep/activity diaries, sleep quality was reported, and frequency of meal and snack consumption was measured using food diaries. In the following six months, participants used a smartphone application to report their influenza-like illness/acute respiratory infection (ILI/ARI) symptoms daily. Mediation analysis of sleep, physical activity, and diet as potential mediators of the effect of shift work on ILI/ARI incidence rate was performed using structural equation modeling with negative binomial and logistic regression. Results Shift workers had a 23% [incidence rate ratio (IRR) 1.23, 95% CI 1.01-1.49] higher incidence rate of ILI/ARI than non-shift workers. After adding the potential mediators to the model, this reduced to 15% (IRR 1.15, 95% CI 0.94-1.40). The largest mediating (ie, indirect) effect was found for poor sleep quality, with shift workers having 29% more ILI/ARI episodes via the pathway of poorer sleep quality (IRR 1.29, 95% CI 1.02-1.95). Conclusions Compared to non-shift workers, shift workers had a higher incidence rate of ILI/ARI that was partly mediated by poorer sleep quality. Therefore, it may be relevant for future research to focus on perceived sleep quality as an underlying mechanism in the relation between shift work and increased infection susceptibility.For nasopharyngeal carcinoma (NPC), radiotherapy is the primary treatment. However, complications occur after radiation to the nasopharynx, which could potentially affect the flying safety. Four fighter pilots with NPC were reported. With early to locally advanced NPC, they received radiotherapy with or without concurrent chemotherapy. The prescribed radiation dose was 70 Gy to the primary tumor over the nasopharynx. Before treatment, all patients presented with various degrees of hearing loss on pure tone audiometry (main frequencies of 20-45 dB at 3-4.5 kHz for affected ears). After the full course of radiotherapy, tumor regression was noticed during months to years of follow-ups. The follow-up audiometry evaluation showed gradually recovered hearing function (average improvement of 5 dB at pretreatment frequencies) in all pilots. They then returned back to the flight line on annual waiver points. Here, we conclude that fighter pilots with NPC could successfully return to the flight line after radiotherapy. However, detailed physical examinations and confirmation of adaptation to flying condition are warranted. © Association of Military Surgeons of the United States 2018. All rights reserved. For permissions, please e-mail [email protected] prognostic role of programmed death ligand-1 (PD-L1) expression in hepatocellular carcinoma (HCC) has been widely studied but the results are controversial. In this comprehensive meta-analysis, we elucidated the clinical value of PD-L1 in HCC. Relevant studies were systematically searched in the Cochrane Library, EMBASE, and PubMed until June 27, 2019. Eligible studies were validated for the prognostic effect of PD-L1 on the overall survival (OS), disease-free survival (DFS), and relapse-free survival (RFS) in HCC using a hazard ratio (HR) and its 95% confidence interval (95% CI). Twenty-three studies with 3529 patients were involved in this meta-analysis. The pooled results revealed that high membrane-bound PD-L1 (mPD-L1) expression was associated with poor OS (HR 1.42; 95% CI 1.12-1.80; P = 0.004) and had no significant correlation with RFS (HR 1.14; 95% CI 0.85-1.54; P = 0.39), and DFS (HR 1.36; 95% CI 0.81-2.28; P = 0.25). The results also indicated that high soluble PD-L1 (sPD-L1) levels were associated with worse OS (HR 2.93; 95% CI 2.20-3.91; P less then 0.00001). In addition, high mPD-L1 expression was associated with high alpha-fetoprotein levels (AFP; OR = 1.46; 95% CI 1.16-1.84; P = 0.001), hepatitis (OR = 0.72; 95% CI 0.54-0.98; P = 0.03), poor tumor differentiation (OR = 0.68; 95% CI 0.55-0.84; P = 0.03), and tumor-infiltrating lymphocytes (OR = 3.39; 95% CI 1.06-10.91; P = 0.04). The mPD-L1 expression had no significant correlation with age, number of tumors, gender, tumor size, liver cirrhosis, vascular invasion, tumor encapsulation, or TNM stage. The study revealed that high mPD-L1 expression in the tumor tissue and high sPD-L1 levels were associated with shorter OS in HCC. Moreover, overexpression of mPD-L1 was significantly associated with poor tumor differentiation, hepatitis, AFP elevation, and tumor-infiltrating lymphocytes. © 2020 The Author(s).BACKGROUND Obesity within the USA is a public health crisis. Nutrition counselling in primary care is an effective yet underutilized intervention because of both health care professional (HCP) barriers and patient barriers. OBJECTIVE The purpose of this study was to (i) identify HCP and patient perceptions, needs and barriers surrounding nutrition counselling, (ii) develop nutrition resources for HCPs and patients and (iii) assess utility of the approach. LKynurenine METHODS Paper surveys were completed by 48 HCPs (response rate 63.2%) and 185 patients in five family medicine clinics. Based on results, nutrition resources were developed and integrated into the electronic medical record. To assess utility, paper surveys were completed by 25 HCPs (response rate 32.9%) after 4 weeks. Results were presented as descriptive statistics. RESULTS Both HCPs and patients indicated that nutrition counselling is necessary to improve dietary behaviours, but barriers prevented HCPs from providing counselling and patients from improving dietary behaviours.
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