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The COVID-19 pandemic precipitated drastic changes in cancer care. Its impact on the U.S. head and neck cancer population has yet to be fully understood. This study aims to understand the impact of pandemic-related changes on the head and neck cancer population. An observational study of head and neck cancer patients at a single institution during the spring of 2020 and 2019 was performed. Clinical characteristics and survival outcomes were analyzed. In 2020, 54 head and neck cancer patients were evaluated in the department of radiation oncology vs. 74 patients seen in 2019; 42% of the patients were female in 2019 versus 24% in 2020 (p = 0.036). The median follow-up time was 19.4 and 31 months for 2020 and 2019, respectively. After adjusting for stage, the relapse-free survival probability at 6 and 12 months was 79% and 69% in 2020 vs. 96% and 89% in 2019, respectively (p = 0.036). There was no significant difference in the overall survival, with 94% and 89% in 2020 and 2019, respectively (p = 0.61). Twenty-one percent of patients received induction chemotherapy in 2020 versus 5% in 2019 (p = 0.011); significantly more treatment incompletions occurred in 2020, 9% vs. 0% in 2019 (p = 0.012). Moreover, the stage-adjusted RFS differed between cohorts, suggesting head and neck cancer patients seen during the initial wave of COVID-19 may experience worse oncologic outcomes.

IntroductionTreatment of hypersensitivity pneumonitis involves removal of the antigen and may include the use of immunosuppression or antifibrotic therapy. It remains unclear whether antifibrotic or immunosuppressive therapy is more beneficial in fibrotic hypersensitivity pneumonitis or if clinical markers can predict a patient's response to therapy.MethodsWe evaluated a retrospective cohort in order to determine if certain clinical characteristics can predict physiologic improvement with immunosuppressive treatment in patients with chronic hypersensitivity pneumonitis. Patients with a diagnosis of hypersensitivity pneumonitis with a moderate, high, or definite confidence according to the American Thoracic Society criteria were included in the study.ResultsOverall immunosuppression did not lead to improvement in % predicted forced vital capacity (FVC%) and % predicted diffusion capacity (DLCO%). Patients with fibrotic hypersensitivity pneumonitis and those with familial interstitial lung disease demonstrated a decline in FVC% predicted as well as DLCO% predicted over one year and the use of immunosuppression does not modify that risk. In contrast, patients with extensive ground glass demonstrated improvement in DLCO% predicted but not FVC% predicted over one year with or without the use of immunosuppression.ConclusionOur study demonstrates that certain radiographic variables trend toward a significant impact on FVC% predicted as well as DLCO% predicted and suggests that antifibrotic therapy may be a better initial choice of therapy in patients with fibrotic hypersensitivity pneumonitis as decline occurred with or without the use of immunosuppression.

This study was conducted on five commercial farms across Victoria, Australia, between September 2018 and November 2019, where the TM status of ewes was within normal ranges before joining. Mix breed ewes (n = 1484) were randomly allocated to receive either nil treatment (Control) or two injections of an ITM product containing zinc (40 mg/mL), manganese (10 mg/mL), selenium (3 mg/mL), and copper (10 mg/mL); 0.2 mL per 10 kg BW (Multimin® plus Copper for Sheep, Virbac (Australia) Pty Ltd., Milperra, NSW, Australia) 30 days before the start of joining and 30 days before the start of lambing. Approximately 90 days after joining, pregnancy status and conception rate were determined by ultrasound. The marking rate was determined approximately four weeks after the end of lambing, and lamb weights were determined at weaning (12 weeks after the end of lambing). In all farms, ITM treatment did not affect the conception rate. The average conception rate was 156 ± 11.0% (p > 0.05). The marking rate of ITM ewes was 9% higher than control ewes (95% Confidence Interval 3–21%). Lambs born to ITM ewes were 2.31 kg heavier at weaning than lambs born to control ewes (p < 0.001). Although not significant, ewe mortality across farms was 1.3% lower in the ITM group than in the control group. On average, ewes treated with ITM pre-joining and pre-lambing produced more and heavier lambs that represent an extra AU$ 2338 per 100 ewes net benefit for the producer. These results help to understand strategic TM supplementation for animal health, performance and farm profitability beyond the treatment of clinical deficiencies.

This article presents a chip-scale package (CSP) based filament light-emitting diodes (LEDs) with a stacked-type structure and a segmented-type luminescence design for higher luminous efficiency and better electrical stability. The innovation strategy improves the luminous efficiency by 7.69% and 18.97% than the traditional dispensing packaged LED filament when the current is at 30 mA and 210 mA, respectively, and reduces the use of red phosphors and green phosphors by 66.7% and 26.2%, respectively. With the increase of the current, the luminous efficiency variations of the stacked-packaged filament are lower than that of the traditional dispensing packaged filament. Moreover, the color temperature of the filament is no longer determined by the calculation of the ratio of various phosphors. The stacked structure and the segmented design can help us to adjust the specified color temperature quickly by changing the proportion and position of the blue chips and the red CSP LEDs.

Current standard of care for oropharyngeal cancers with positive surgical margins and/or extracapsular extension is adjuvant chemoradiotherapy. It is unknown whether HPV+ oropharyngeal cancer benefits from this treatment intensification.To investigate the outcomes of HPV+ patients treated with adjuvant radiotherapy alone when chemoradiotherapy was indicated based on high risk pathological features. They were compared with high risk HPV+ patients treated with adjuvant chemoradiotherapy.All high risk HPV+ oropharyngeal cancer patients (9) who received radiotherapy alone were identified. We also identified 17 patients who received chemoradiotherapy as a comparison group. Median follow up time was 37.3 months.No local failures developed in adjuvant radiotherapy group. There was 1 distant recurrence in this cohort and 3 in CRT cohort. Regarding toxicity, 8 (47.1%) chemoradiotherapy patients had >10 lb. weight loss (p = 0.013), despite 75% of them having a percutaneous endoscopic gastrostomy tube placed. No individuals in radiotherapy group experienced a >10 lb. weight loss and none required a gastrostomy tube.This series provides preliminary evidence suggesting that the omission of concurrent chemotherapy to adjuvant radiotherapy may offer comparative local control rates with a lower toxicity profile in the setting of HPV+ patients with traditional high risk features.

We are reporting a case of a 75-year-old man with multiply recurrent IgA-lambda multiple myeloma status post multiple rounds of chemotherapy, autologous stem cell transplantation, and palliative radiation therapy for diffuse bone lesions. Approximately 15 years after original diagnosis, he developed secondary cutaneous plasmacytomas of the right arm, right chest wall, and right upper back over the course of several months. He underwent palliative involved field 3D conformal photon or en face electron therapy concurrently with various chemotherapy regimens and achieved good to complete response with palliation of pain at the irradiated sites. He died of complications related to his disease approximately 7 months after developing skin lesions. The case presented is unique for dermal involvement of myeloma treated with palliative involved field radiation.