Search

The United States Appalachian region harbors a higher cancer burden than the rest of the nation, with disparate incidence of head and neck squamous cell carcinomas (HNSCC), including oral cavity and pharynx (OC/P) cancers. Whether elevated HNSCC incidence generates survival disparities within Appalachia is unknown. To address this, HNSCC survival data for 259,737 tumors from the North American Association for Central Cancer Registries 2007–2013 cohort were evaluated, with age-adjusted relative survival (RS) calculated based on staging, race, sex, and Appalachian residence. Tobacco use, a primary HNSCC risk factor, was evaluated through the Behavioral Risk Factor Surveillance System from Appalachian states. Decreased OC/P RS was found in stage IV Appalachian white males within a subset of states. The survival disparity was confined to human papillomavirus (HPV)-associated oropharyngeal cancers, specifically the oropharynx subsite. This correlated with significantly higher smoking and male smokeless tobacco use in most Appalachian disparity states. Lower survival of Appalachian males with advanced-stage HPV-associated oropharyngeal cancers suggests pervasive tobacco consumption likely generates more aggressive tumors at HPV-associated oropharynx subsites than national averages. Comprehensive tobacco and HPV status should therefore be evaluated prior to considering treatment de-intensification regimens for HPV-associated oropharyngeal cancers in populations with high tobacco consumption. [ABSTRACT FROM AUTHOR]

Background and Purpose: Pain is common among older adults with dementia. There are nonpharmacological options for managing pain in this population. However, the effects of physical therapist-delivered interventions have not been summarized. The purpose of this systematic review was to summarize the literature on physical therapist-delivered interventions in randomized trials for reducing pain among older adults with dementia. Methods: A systematic search of MEDLINE/PubMed, CINAHL, PsycINFO, and Web of Science was conducted for randomized trials of pain management in individuals 60 years or older with medically diagnosed dementia of any severity. Included studies addressed the effects of nonpharmacological physical therapist-delivered interventions on pain outcomes. Pain outcomes included patient or caregiver self-report, observational or interactive measures. Independent reviewers extracted relevant data and assessed methodological quality using the PEDro scale. Results and Discussion: Three studies (total = 222 participants; mean age range = 82.2-84.0 years; 178 [80.2%] females) met inclusion criteria. PEDro scores ranged from 4 to 8/10. Interventions included passive movement and massage. Pain outcomes included the observational measures Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC), Pain in Advanced Dementia (PAINAD), and Doloplus-2 Scale. Passive movement did not show better results when compared with no treatment, while massage showed pain-reducing effects in 1 study compared with no treatment. Conclusions: The evidence supporting pain-reducing physical therapy interventions for patients with dementia is limited. There is a clear gap in knowledge related to evidence-based physical therapy for managing pain in this population. Future studies should examine active physical therapist-delivered interventions and utilize interactive pain measures. [ABSTRACT FROM AUTHOR]

A taxonomic revision of Hypotrachyna subgenus Parmelinopsis in eastern North America is presented based on molecular phylogenetic analyses of ITS and mtSSU data, extensive field observation and analyses of chemical and morphological data. Each species is described, illustrated with photographs, and the distribution in the region is mapped. An identification key is also presented. Eleven species are recognized: H. afrorevoluta, H. appalachensis, H. britannica, H. cryptochlora, H. horrescens, H. kauffmaniana, H. minarum, H. mcmulliniana, H. revoluta, H. showmanii and H. spumosa. Extensive discussion of prior studies is provided, particularly with respect to the delimitation of H. afrorevoluta and H. revoluta. Hypotrachyna kauffmaniana is described from the central and southern Appalachian Mountains and separated from H. afrorevoluta and H. revoluta by its ascending secondary lobes and pustulose soralia that are primarily confined to the secondary lobes. Hypotrachyna horrescens is shown to correspond to a taxon with narrow lobed, small thalli with ciliate isidia. Hypotrachyna mcmulliniana is described from material collected throughout southeastern North America that is chemically identical to H. horrescens but differs in having larger thalli and sparsely ciliate isidia. Hypotrachyna appalachensis is described to accommodate material previously referred to H. minarum but that differs in the production of 4,5-di-O-methylhiascic acid in high concentrations (vs. absent or present as a trace in H. minarum). Hypotrachyna britannica is reported for the first time from North America. [ABSTRACT FROM AUTHOR]

Bulk electrodes are used in molten salt electrolysis as consumable graphite anodes for existing aluminium production (producing CO 2) as well as for oxygen evolution anodes in future zero emission manufacturing processes, such as direct iron electrolysis. Here, graphite electrodes with different geometry, roughness, density, and size were assessed for their kinetic behaviour and gas evolution stability in a molten alkali-metal (Li-Na-K) carbonate salt at 600 °C. It is suggested through comparative assessment of controlled electrode sizes and geometry that radial diffusion at a small (5 mm diameter disc) electrode is likely to influence performance. Roughened electrodes and electrodes of varying porosity also impacted polarisation behaviour which was ascribed to changes in electrolyte wetting observed in separate studies, conducted under similar conditions. It was also seen that 3-dimensional cone and slant type electrodes on angles of 75° increased the electrode performance. Enhanced kinetics were observed by a decreasing Tafel slope from 254 mV.decade−1 to 188 mV.decade−1 for 45° and 75° slant electrodes, respectively. The apparent improved performance for identical electrode material is discussed to involve influence from radial diffusion of reactants, modified via electrode geometry. Additional work is required to confirm this. It was concluded that to fairly compare oxidation of graphite materials in molten carbonate salts, electrodes of 10 mm diameter equivalent should have the same geometry and consistent inclination angle (of below 45°), as well as control of bulk density and resulting porosity. This observation may well also apply to other systems and should be considered in experimental design. [ABSTRACT FROM AUTHOR]

The authors reflect on how the COVID-19 pandemic offers an opportunity to address issues on health inequalities in the Eastern Mediterranean region. Topics include the social determinants of health, the Commission on Social Determinants of Health created by the World Health Organization Regional Director of Eastern Mediterranean, and the risks facing internally displaced persons (IDP), refugees, and migrants.