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Background: Malnutrition is a common issue in patients with head and neck squamous cell carcinoma and has a negative effect on surgical outcomes. Objective: We attempted to determine which malnutrition diagnostic variables can be used as predictors of postoperative complications in patients with head and neck squamous cell carcinoma. Methods: Forty-one patients undergoing surgery for head and neck squamous cell carcinoma were submitted to a prospective evaluation. Biochemical data, anthropometric measurements and evaluation of body composition were used in the nutritional analysis. Results: Twenty-two patients (53.6%) developed complications. Serum albumin measured on the first postoperative day was the only variable that significantly differed between groups. A cut-off value of 2.8 g/dL distinguished between patients with a complicated and uncomplicated postoperative course. Normalization of albumin levels occurred more frequently and more rapidly in the noncomplicated group. Conclusion: Serum albumin measured on the first postoperative day was the only variable that was a predicter of postoperative complications after major head and neck squamous cell carcinoma surgery.

Background Metformin slows tumor growth and progression in vitro, and in combination with chemoradiotherapy, resulted in high overall survival in patients with head and neck cancer squamous cell carcinoma (HNSCC) in our phase 1 clinical trial (NCT02325401). Metformin is also postulated to activate an antitumor immune response. Here, we investigate immunologic effects of metformin on natural killer (NK) and natural killer T cells, including results from two phase I open-label studies in patients with HNSCC treated with metformin (NCT02325401, NCT02083692).Methods Peripheral blood was collected before and after metformin treatment or from newly diagnosed patients with HNSCC. Peripheral immune cell phenotypes were evaluated using flow cytometry, cytokine expression by ELISA and/or IsoLight, and NK cell-mediated cytotoxicity was determined with a flow-based NK cell cytotoxicity assay (NKCA). Patient tumor immune infiltration before and after metformin treatment was analyzed with immunofluorescence. NK cells were treated with either vehicle or metformin and analyzed by RNA sequencing (RNA-seq). NK cells were then treated with inhibitors of significant pathways determined by RNA-seq and analyzed by NKCA, ELISA, and western blot analyses.Results Increased peripheral NK cell activated populations were observed in patients treated with metformin. NK cell tumor infiltration was enhanced in patients with HNSCC treated with metformin preoperatively. Metformin increased antitumorigenic cytokines ex vivo, including significant increases in perforin. Metformin increased HNSCC NK cell cytotoxicity and inhibited the CXCL1 pathway while stimulating the STAT1 pathway within HNSCC NK cells. Exogenous CXCL1 prevented metformin-enhanced NK cell-mediated cytotoxicity. Metformin-mediated NK cell cytotoxicity was found to be AMP-activated protein kinase independent, but dependent on both mechanistic target of rapamycin and pSTAT1.Conclusions Our data identifies a new role for metformin-mediated immune antitumorigenic function through NK cell-mediated cytotoxicity and downregulation of CXCL1 in HNSCC. These findings will inform future immunomodulating therapies in HNSCC.

In this article, we explore the relevance of a focus on professional formation (Bildung) in health education in the context of interprofessionalism as a condition for working in health care. We outline general aspects of the concept of professional formation and distinguish two key elements: an adaptation and a transgression orientation. We argue that a transgression orientation is important in health education and professional formation today. Partly as an end in itself, given fundamental features of human existence, partly because the interprofessional demand in health professional work means that the distinction between adaptation and transgression orientation collapses: adaptation to contemporary conditions in health care requires, both a temporal and a spatial transgression orientation in the form of a perspective flexibility that allows the development of new professional perspectives as well as the appropriate consideration of different existing professional perspectives. Drawing on considerations of philosophy of existence, and on qualitative interviews with practicum teachers, we highlight key conditions and obstacles for a focus on professional formation to be feasible in clinical education. Among other things, we highlight knowledge of and experience with each other's professions, a common cause and professional goals, and not least an educational mindset and a learning culture that is not too rigid and over-controlling. On the other hand, it is important to focus on first-hand experience of interprofessionality framed by good communication and shared reflections on interprofessional practice. The latter is hampered by different professional languages and identities, physical distance between clinical practice and the workplace, and by a lack of knowledge of and experience with each other's professional practices, a common cause and professional goals, and, not least, an educational mindset and a learning culture that is not too rigid and over-controlling. On the other hand, it is important to focus on first-hand experience of interprofessionality framed by good communication and shared reflections on practice. The latter is hampered by different professional languages and identities, physical distance between clinical practice sites and pressure on resources in both health care and training.

Abstract A method for achieving open‐phase fault tolerant operation of a dual‐inverter‐based traction drive with charging capability is presented. This method utilises a contactor to connect the switching nodes of the two half bridges which are normally used for AC charging in this dual inverter configuration. These half bridges are then modulated to provide a path for zero‐sequence current and enhance the available voltage vector space of the drive by injecting a controllable common‐mode voltage between the two inverters. A control method and five‐level modulator based on zero‐sequence voltage control and phase shifted carriers are introduced to accommodate this novel remedial method. Using this approach, the open‐phase faulted dual inverter drive is able to operate with twice the speed range of the conventional open‐phase fault tolerant approach, which is to provide a path for zero‐sequence current by connecting the negative DC rails of the two inverters with a contactor. Simulation and experimental results with a prototype dual inverter drive are presented to validate the theory of the new control and modulation method. The experimental results showcase the proposed algorithms performance by dynamically responding to an open‐phase fault and starting from standstill, thereby proving its validity for an electric vehicle application.

Restoring oxygenation in hypoxic tumors might lead to favorable oncological outcome of patients if combined with standard multimodal therapy regimens. Here the authors report a phase Ib clinical trial of anti-hypoxic myo-inositol trispyrophosphate (ITPP) in hepato-pancreato-biliary neoplasms.

Abstract Cheese whey is the main by-product obtained in the production of cheese. Despite its high nutritional value, approximately half of the whey volume generated is still disposed incorrectly, which causes damage to the ecosystem due to the high cheese whey pollutant load. Therefore, it is important to use this by-product and its components in an increasing number of applications, especially as food ingredient. This review aimed to show the technology of production of butter from whey cream, as well as showing the physico-chemical, sensory, and nutritional characteristics of the product. There were no significant variations in the physico-chemical composition of milk cream butter and whey cream butter in the literature available. As the technology to produce whey butter is quite simple, this by-product has potential to be exploited by the dairy industry. Additionally, further studies on production process, characterization, and sensory analysis are required to enable its large-scale production.

In 1993, the skeletal remains of a female corpse were found in Burgenland, Austria. Initial identification of the approximately 25–35-year-old female appeared impossible, but the case was reopened 23 years later. By applying biogeochemical isotope methods to her body tissues, the geographical origin of the unknown corpse could be predicted. The results of the C, N, S, H, Sr, and Pb isotope analyses suggested that the female did not originate from Europe and most likely spent her youth in the northern Caribbean. Using these findings, the police were able to identify the woman within 2 weeks. The female came from the Dominican Republic and resided in Austria for only a short period before she was murdered. This case shows that isotope biogeochemistry investigations can provide the police with crucial information that enables unknown persons to be identified. Keypoints C-N-S-H and Sr-Pb isotope analyses were applied to human remains associated with a cold case. It was possible to determine the region of origin of the unknown deceased individual as the northern Caribbean. After 23 years, the murder victim was successfully identified.

Abstract A three‐coil decoupled transmitter is developed for the inductive power transfer system of electric vehicle charging. The three‐coil decoupled transmitter consists of three overlapping rectangular coils with magnetic mutual decoupling and is capable of overcoming large receiver lateral misalignment up to 20 cm. A current optimization method is advanced to derive transmitter coil currents for the multi‐phase system that minimizes the coil loss through optimizing the current distribution among transmitter coils. The optimized current distribution reduces the maximum leakage flux by around 40% compared to the best alternative excitation method. The compensation strategy provides unity power factor for high‐power transfer phases and allows a single set of compensation capacitors to be used regardless of receiver alignment. The three‐coil decoupled transmitter is compatible with a typical three‐phase inverter for industrial practical application, which halves the power electronic switches used with previous topologies. The simulation verification is performed at 3.3 kW, achieving 93.76% efficiency at perfect alignment and 92.54% efficiency at 20 cm misalignment. The experimental verification is implemented at 3.3 kW with 200 mm ground clearance, realizing a 92.97% efficiency at perfect alignment and 90.57% efficiency at 20 cm misalignment.

This interdisciplinary investigation of the human remains of Balduin Helm, one of the most important abbots of the Fürstenfeld monastery, provides novel information on this historic individual. This is particularly interesting since Balduin, during the early 18th century, was involved in the renovation of this large Bavarian monastery. Metastatic prostate cancer was found as evidenced by multiple mixed osteolytic–osteoblastic bone lesions in all available vertebral bodies, fragments of both os coxae, and isolated metastases in skull bones. Distribution, radio- and histomorphology, and especially the immunohistochemical detection of prostate-specific antigens in those metastases definitively confirm this diagnosis. Further investigation, especially by stable isotope analysis, showed a balanced high-level diet with considerable contribution from animal protein and significant freshwater fish. These additional findings suggest a significant radiocarbon reservoir effect as an explanation for a "too old" radiocarbon date. Finally, the obviously high-level protein diet may have contributed to the tumorigenesis which caused the death of the abbot at an advanced age. [ABSTRACT FROM AUTHOR]

As with many industries, the early life science R&D drug discovery sector is facing growing pressure and higher demands on products in terms of cost, quality, and time‐to‐market. Additionally, the complexity of involved targets and systems, requirements for rapid, safe, and developable candidates are increasing. The drug discovery market, often regarded as rather conservative, relies more and more on advanced technologies. It is therefore a significant task for suppliers to create good solutions that meet customer requirements. The life science industry has a long tradition of using projects as the preferred method to manage these complex systems developments, such as the production of target proteins, screening of compounds, and follow‐up of hit compounds. When applying the project approach, the level of uncertainty is usually high, and the risk of those uncertainties must be managed starting in the early planning phase. Thus, this paper focuses on the issue of how to manage risks in the early project planning phase. We first review state‐of‐the‐art practices in risk management for complex systems project management and identify an important framework, Novelty‐Technology‐Cost‐Pace (NTCP), and apply it to successful risk management for early life science projects. Through an in‐depth case study in the life science industry, we demonstrate a systemic integration of the NTPC framework into project planning. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the prevalence of type 2 diabetes (T2D) among Danish nursing home residents (aged ⩾65 years). Methods: Individuals with T2D in the Danish population of older adults in 2018 were identified using a Danish diabetes register based on administrative and clinical register data. Data on age, sex, type of housing, educational level and place of origin were obtained from various high-quality administrative registers. We calculated frequencies of T2D among older adults living in nursing homes and in other types of housing. We performed a multiple logistic regression analysis to estimate the odds ratio (OR) of T2D among people living in nursing homes and adjusted for sex, age, educational level and place of origin. Results: All Danish older adults aged ⩾65 years, alive and living in Denmark on 31 December 2018 were included (N =1,170,517). Nursing home residents accounted for 37,891 older adults, and of these, 19% had T2D, whereas 14% of older adults living in other types of housing had T2D. According to the multiple logistic regression analysis, nursing home residents had a higher OR of having T2D compared to older adults living in other types of housing (OR=1.47; confidence interval 1.43–1.51) when adjusting for socio-demographic factors. Conclusions: The prevalence of T2D in nursing home residents exceeds the prevalence in the background population at ⩾65 years of age. This indicates a need for increased focus on individualised interdisciplinary care plans aimed at maintaining physical function and maximising quality of life for this group of vulnerable older adults. [ABSTRACT FROM AUTHOR]