ObjectivesDespite modern treatment regimens, overall survival in head and neck squamous cell carcinomas (HNSCC) is less than 50% due to local and systemic disease recurrency. The current study aims to identify molecular markers in primary tumor specimens that predict the risk for local and systemic recurrency at the time of initial diagnosis.MethodsThe study included clinic-pathological data of 1,057 HNSCC. MMP2/9, TIMP1/2, CXCR4, and CXCL12 immunohistochemistry was done in 150 randomly selected specimens. For statistics, we employed Chi square, Fisher exact, and Student's t-test. Overall survival (OS) was calculated by Kaplan–Meier and log-rank test. Prognostic variables were subsequently evaluated by Cox regression for forward selection.ResultsCXCR4 positive specimens demonstrated a significant increased risk for tumor recurrency associated death (rT: HR 10.07; p=0.001 / rN: HR 5.04; p=0.013 / rM: HR 2.49; p=0.029) when compared with their unaltered counterparts. Expression of MMP9, TIMP2, CXCR4, and CXCL12 was significantly increased in distant metastasized patients (p<0.0001) and showed significant cross-correlation. In addition, CXCR4 positivity was associated with an increased risk to die due to enhanced T or N status (T1/2 vs. T3/4: HR 5.78; p=0.017; N0 vs. N+: HR 5.18; p=0.033).ConclusionCXCR4 positivity in tumor samples at initial diagnosis were associated with reduced overall survival, in particular with respect to increasing T/N status, local and systemic recurrency.
Background: Educational role is one of the most important roles of librarians, which has taken on wider dimensions. A review of the literature on the training programs provided by librarians revealed an evolution of the ideas and trends in this area. This systematic review aimed at providing a clear image of the available educational programs, their target groups, and the way they are performed.
Methods: This systematic review was done to identify different aspects of the educational role of medical librarians. It was conducted on the studies published in PubMed database during 2005 and 2015. All the studies that described the educational activities of medical librarians were considered for inclusion. All the studies were evaluated by 2 researchers using a checklist, which was developed as an assessment tool. Variables that were considered were as follow: skills taught by librarians, target group, providing training on information resource, teaching method, and session location. After data extraction process and appraisal, the mentioned variables were classified into main categories.
Results: A total of 24 studies met the inclusion criteria. The training skills taught by librarians were classified into 3 main groups: information literacy, evidence-based practice, and health literacy. The target groups were library users, patients, and health professionals. Group training was provided, and if necessary, personal training was also offered. Recently, synchronous online training has also been added to the training methods. Most of the training programs are held in classrooms.
Conclusion: By categorizing different aspects of training programs, this study aimed at providing a basis for designing a framework to identify the tasks of educational librarians in health sciences.
Background: To analyze whether distant metastatic outgrowth in different head and neck malignancies (HNM) underlies the CXCR4-CXCL12 axis as overriding molecular mechanism. Methods: Clinic-pathological data of 1,250 HNM was included. HNM were collected due to different capability to exhibit distant metastasis comprising basal cell, squamous cell, and adenoid-cystic carcinoma as well as melanoma. MMP2/9, TIMP1/2, CXCR4, and CXCL12 immunohistochemistry was done in 190 randomly selected specimens.Results: Immunohistochemistry visualized a significant increase in MMP2/9, TIMP1/2, CXCR4, and CXCL12 protein expression following the clinical occurrence of distant metastasis. CXCR4, CXCL12, and TIMP2-expression significantly increases with number of affected organs by distant metastasis. Cox regression demonstrated CXCR4-overexpression and advanced T-status being independent risk factors of distant metastasis associated death.Conclusion: The CXCR4-CXCL12 axis is associated with the occurrence of distant metastases in different HNM. The increased risk of distant metastasis associated death was identified at primary tumour site and, therefore, potentially influences further treatment protocols.
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