Objectives
To describe the impact that the coronavirus disease 2019 (COVID-19) pandemic had on the presentation of patients with head and neck cancer in a single tertiary care center.
Study Design
...Retrospective cohort study.
Setting
Academic institution.
Methods
We performed a retrospective review of patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC) who presented as new patients between September 10, 2019, and September 11, 2020. Patients presenting during the 6 months leading up to the announcement of the pandemic (pre–COVID-19 period) on March 11, 2020, were compared to those presenting during the first 6 months of the pandemic (COVID-19 period). Demographics, time to diagnosis and treatment, and tumor characteristics were analyzed.
Results
There were a total of 137 patients analyzed with newly diagnosed malignancies. There were 22% fewer patients evaluated during the COVID-19 timeframe. The groups were similar in demographics, duration of symptoms, time to diagnosis, time to surgery, extent of surgery, and adjuvant therapy. There was a larger proportion of tumors classified as T3/T4 (61.7%) in the COVID-19 period vs the pre–COVID-19 period (40.3%) (P = .024), as well as a larger median tumor size during the COVID-19 period (P = .0002). There were no differences between nodal disease burden (P = .48) and distant metastases (P = .42).
Conclusion
Despite similar characteristics, time to diagnosis, and surgery, our findings suggest that there was an increase in primary tumor burden in patients with HNSCC during the early COVID-19 pandemic.
Granulosa Cell Tumour (GCT) is a rare malignant ovarian tumour. Adult GCT variety is more common than juvenile variety and occurs usually in postmenopausal women. It showed a spectrum of the imaging ...findings due to various histological appearances. It may present with solid masses, multilocular cystic lesion or completely cystic lesion. Here, authors present an interesting case of a 27-year-old young female, who presented with a large lump in the abdomen. On Magnetic Resonance Imaging (MRI) there was a large well-defined, multilocular cystic lesion at superior aspect of the lesion and complex cystic, solid mass at inferior aspect. Functional MRI like diffusion weighted imaging which provides good image contrast helped in determining the malignancy despite a benign diagnosis on ultrasound guided biopsy and furthering the patient for histopathological examination to come to a final diagnosis.
Speech-language pathologists (SLPs) utilize counseling to support the psychological wellbeing of people with post-stroke aphasia, however, SLPs receive variable, usually limited, counseling ...education. Counseling education may be effective in improving SLPs' knowledge, skills, and confidence in counseling in post-stroke aphasia.
We aimed to evaluate the feasibility and preliminary efficacy of a novel online counseling education program for SLPs working with people with post-stroke aphasia.
Our study was a Phase II, two-arm pilot randomized controlled trial with a waitlist control. Participants (n = 49) were stratified by previous counseling training (≥1 day) and co-work with psychologists when addressing psychological wellbeing in post-stroke aphasia, and randomized to either the education program or waitlist control arm. We developed an education program (7-hours self-directed learning; 3-hour online workshop) for the trial. Feasibility outcomes included SLP recruitment, workshop attendance, and participant attrition at follow-up. Participants' counseling self-efficacy and self-rated competency were assessed pre- and post-program (primary endpoint) and at 5-week follow-up.
Forty-four (90%) participants attended the workshop with forty-one (84%) participants completing the trial. There was a significant interaction (large effect size) between time and group supporting a positive effect of the program on counseling self-efficacy, F(1,44) = 39.402, p < . 0005, η
p
2
= . 472 and self-rated competency for counseling, F(1,44) = 31.824, p < . 0005, η
p
2
= . 420. The effects were maintained at follow-up with self-rated competency scores demonstrating further significant improvement.
The demonstrated feasibility and preliminary efficacy of this online counseling program warrant a future definitive trial.
Set in the context of the COVID-19 pandemic this paper examines the consumption choices of participants during the pandemic, presenting an exploratory study of how consumption was used as a means of ...coping with the crisis. It investigates the nature of consumption decisions and the key factors that influenced these choices. The findings suggest that the uncertainties, the pressures, and the unknown aspects of COVID-19 influenced participants. Government and media communication did little to inform the public and with the lack of information, consumption was used as a coping strategy. Moreover, the article details the pleasure experienced by participants of consuming luxury in the crisis and the hedonic nature of luxury consumption. These findings have direct relevance to future research on how luxury consumption is perceived and used to cope with crisis situations.
In the current scenario of agricultural economy of Punjab, the viability issue of farming, particularly of small land holders is being highlighted by the academicians and policy makers. A farm is ...considered viable when its income surpasses its expenses, proving its potential to not only cover operational costs but also provide a surplus. On the basis of this criterion, in Punjab 93 per cent of small farms were viable as they were able to cover the crop production costs. However, farm household viability is dependent on generating a positive economic surplus, which is calculated by combining off-farm revenue with farm business income and deducting the domestic expenditures of the farm household. In this way 68 per cent of farm household were viable as these were able to generate sufficient income to cater their farm as well as household needs. It is observed that some farm holdings were nonviable due to insufficient farm income from agricultural pursuits, while the viability of the farm household was attained through non-farm income of the household. So far as the income and expenditure level of small and marginal farmers is concerned, an average annual income of these farm household (Rs. 102830) was much lower than their annual expenditure (Rs 142568). The logit model infers that family size, food expenditure and non-food expenditure reduced the viability, whereas crop income, dairy income and off-farm income have positively affected the viability of these farms. To enhance the viability of these farms, it is crucial to focus on generating off-farm employment and income in rural areas.
A high diversity of plant defenses may be a response to herbivore diversity or may be collectively more toxic than single compounds, either of which may be important for understanding insect-plant ...associations. Monoterpenes in conifers are particularly diverse. We tested the fumigant toxicity of four monoterpenes, alone and in combination, to mountain pine beetles,
Dendroctonus ponderosae
, in the context of the beetles' individual body traits. Chemical structures of tested monoterpene hydrocarbons had modest effects on beetle survival, mass loss, water content and fat content, with (
R
)-(+)-limonene tending to be more toxic than (−)-α-pinene, (−)-β-pinene, and (+)-3-carene. Monoterpene diversity (all qualitative combinations of one to four monoterpenes) did not affect toxicity. Concentration (0 to 1200 ppm) of individual monoterpenes was a strong determinant of toxicity. Beetle body size and body condition index strongly and positively affected survival during monoterpene treatments. Larger beetles in better condition lost proportionally less mass during exposure, where proportion mass loss negatively affected survivorship. Toxicity was much more associated with water loss than with fat loss, suggesting that a main cost of detoxification is excretion, a process that has received little attention. These results provide insight into the determinants of beetle success in historic and novel hosts that differ in monoterpene composition and concentration. We also suggest that water availability will affect beetle success directly through their ability to tolerate detoxification as well as indirectly through host responses to drought.
PDF
