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This study aimed to gain an insight into the lived experience of Overseas Filipino Workers (OFWs) who lost their family members due to COVID-19 during the lockdown in 2020. Five OFWs volunteered to participate in this study and underwent online semi-structured interviews. An interpretative phenomenological approach guided the data analysis, through which four major themes were derived: (1) experiencing the emotional strains of unexpected death while physically distant; (2) enduring the absence of traditional mourning rituals; (3) managing grief from a distance; and (4) finding closure through physical and symbolic presence. These findings shed light on how OFWs experienced loss and grief during the lockdown, as well as how they coped amidst the distance and eventually finding a degree of closure.

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BACKGROUND: High-flow nasal cannula therapy (HFNC) may increase aerosol generation, putting healthcare workers at risk, including from SARS-CoV-2. AIM: To examine whether use of HFNC increases near-field aerosols and whether there is an association with flow rate. METHODS: Subjects aged four weeks to 24 months were recruited. Each child received HFNC therapy at different flow rates. Three stations with particle counters were deployed to measure particle concentrations and dispersion in the room: station 1 within 0.5 m, station 2 at 2 m, and station 3 on the other side of the room. Carbon dioxide (CO2) and relative humidity were measured. Far-field measurements were used to adjust the near-field measurements. FINDINGS: Ten children were enrolled, aged from 6 to 24 months (median: 9). Elevated CO2 indicated that the near-field measurements were in the breathing plane. Near-field breathing plane concentrations of aerosols with diameter 0.3-10 µm were elevated by the presence of the patient with no HFNC flow, relative to the room far-field, by 0.45 particles/cm3. Whereas variability between subjects in their emission and dispersion of particles was observed, no association was found between HFNC use, at any flow rate, and near-field particle counts. CONCLUSION: This method of particle sampling is feasible in hospital settings; correcting the near-patient aerosol and CO2 levels for the room far-field may provide proxies of exposure risk to pathogens generated. In this pilot, near-patient levels of particles with a diameter between 0.3 and 10 µm and CO2 were not affected by the use of HFNC.

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BACKGROUND: Kawasaki disease (KD) is the most common cause of acquired heart disease in children in the United States. By monitoring trends in patient numbers and demographics during a 5-year period, we were able to explore the relationship between climate, ethnicity, socioeconomic status and susceptibility to KD. METHODS: We conducted active surveillance for all patients hospitalized with KD in San Diego County from 1994 through 1998. Data on seasonal variation in monthly rainfall and temperature were obtained from the US Meteorological Service. Patient sex, age, date of admission and self-reported ethnicity were identified from patient medical records. Socioeconomic status was assessed on the basis of insurance status among patients hospitalized at a single institution. RESULTS: During the 5-year period there were 169 cases of KD in San Diego County. The overall annual incidence of KD in children < 5 years of age ranged from 8.0 to 15.4/100 000. KD incidence was inversely associated with average monthly temperature (r = -0.47, P < 0.001) and positively associated with average monthly precipitation (r = -0.52, P < 0.001). Asian/Pacific Islanders < 5 years of age were 2.7 times as likely and Hispanics were one-third as likely to be hospitalized for KD than children from all other ethnic groups combined. Children with private or military insurance in all ethnic groups were more likely to have a diagnosis of KD than children with government assistance or no insurance. After controlling for insurance status, only Asian/Pacific Islanders remained at increased risk (rate ratio, 2.14) for KD relative to all other ethnic groups combined. CONCLUSION: KD is a common childhood vasculitis of unknown etiology. The skewed ethnic distribution and seasonality are consistent with the hypothesis that KD is an infectious disease that is influenced by environmental and genetic factors.

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The National Cancer Institute has recognized the need for minority participation in clinical trials as a means to enhance cancer outcomes in minority populations and to validate the outcomes of clinical research. In 1994, Louisiana State University Medical Center in New Orleans was granted an award by the National Cancer Institute to establish a Minority-Based Clinical Community Oncology Program. This article outlines the Louisiana State University's Minority Based Clinical Community Oncology Program. During the initial funding period, the Program has established a regional network of cancer physicians and healthcare professionals to provide state-of-the-art cancer treatment and prevention trials to South Louisiana for indigent and minority populations who otherwise would have little access to this care. Because of the success of the Program in patient accrual to both cancer treatment and cancer prevention and control protocol trials, Louisiana State University Medical Center has applied for a continuation of funding for the Program for the next five years.

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The survival of 117 patients with carcinoma of the prostate treated with radiation at SUNY-Health Science Center at Brooklyn and Kings County Hospital Center was analyzed according to their pretreatment method of diagnosis. Sixty-four patients (54.7%) underwent a transurethral resection of the prostate (TURP) for obstructive symptoms prior to definitive therapy, while 53 patients (45.3%) were diagnosed with needle biopsy. The overall 5-year survival rate was 46% in the needle biopsy group and 38% in the TURP group. Black and white patients with high Gleason scores (7 to 10) and black patients with low-grade tumors who underwent TURP had an adverse 5-year survival rate compared with those patients diagnosed by needle biopsy. The 5-year survival rate of patients with high Gleason scores comparing needle and TURP was 37% versus 16%. The 5-year survival rate of black patients with low-grade tumors comparing needle biopsy versus TURP was 50% and 22%, respectively, although not statistically significant because of the small sample size. When evaluated by stage, there was no difference in survival rates of TURP versus needle biopsy. Black patients who underwent TURP had a 28% 5-year survival rate compared with a 44% 5-year survival rate in white TURP patients. This analysis reveals that black and white patients with high-grade tumors and black patients, even with low-grade tumors, may have a lower survival rate if they undergo TURP prior to radiation, but this may be due to higher stage and larger volume disease in these patients.

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We retrospectively studied 80 patients, less than 35 years old, who were being treated for invasive cervical carcinoma at Charity Hospital of Louisiana in New Orleans. The period covered by the study was March 1980 to November 1989. The study group represented 9.3% (80/862) of the total patients seen with the disease. Disease stage was IB in 50 patients, IIA in 4, IIB in 14, IIIA in 5, IIIB in 6, and IVA in 1 patient. Histopathologic classes included 74 squamous cell carcinomas, 3 adenosquamous carcinomas, 2 adenocarcinomas, and 1 anaplastic carcinoma. Treatment used was either radical hysterectomy, irradiation alone, or irradiation followed by hysterectomy. Five-year actuarial survival rates were as follows: stage IB, 81.6%; stage IIA, 25.0%; stage IIB, 29.8%; stage IIIA, 20.0%; and stage IIIB, 33.4%. The only patient with stage IV cancer died of disease. Our findings do not reveal a relationship between age and survival in stage IB carcinoma of the cervix, and the numbers in the other stages are too small to comment on.

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The most important predictors of long-term survival in patients with adenocarcinoma of the prostate are histological grade and stage of disease. However, the role of other epidemiological factors, particularly age and race, remains controversial. There is a school of thought that black patients and younger patients have a biologically more aggressive disease. We analyzed the survival of 914 patients (867 whites and 47 blacks) with localized adenocarcinoma of the prostate treated with external beam irradiation from the Connecticut SEER Tumor Registry data base. Patients were treated from 1973-1987, and those with Stages A1, A2 and D2 were excluded. Patients < or = 60 years of age had a 5-year survival rate of 72% compared to 61% for those > 60 years of age (p = 0.06). When stratified by race, white patients had a 63% 5-year survival rate versus 47% in black patients (p = 0.02). When analyzed by race and age, and age-race interaction was noted. Although younger whites fared better than older whites, 77% versus 61% survival at 5 years (p = 0.02), younger blacks fared worse than older blacks, 31% versus 52% survival at 5 years (p = 0.21). Blacks, on average, presented at an earlier age than whites, 65 years versus 69 years (p = 0.001). Both races had similar stage and similar grade of disease. In older patients, both races presented with similar stage and grade of disease and had similar survival. However, in the younger age group, black patients presented with similar grade, but higher stage disease than whites. This may explain the worse survival in young blacks compared to young whites, 31% versus 77% at 5 years (p = 0.007). Multivariate analysis revealed that, even controlling for stage and grade, blacks still fared worse than whites. Increased age was associated with decreased survival in whites but increased survival in blacks.

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PURPOSE: 141 patients with chordoma and chondrosarcoma of the base of skull and cervical spine were treated with proton and photon irradiation between 1980 and 1989. The local disease was controlled in 111 of these patients. This study reviews the 26 patients who have had their disease recur, and who have evaluable diagnostic studies to examine for probable causes of recurrence. METHODS AND MATERIALS: The histologies of the recurrent tumors were 21 non-chondroid chordomas, two chondroid chordomas, and three chondrosarcomas. The prescribed doses ranged from 67 Cobalt-Gray-Equivalent (CGE) to 72 CGE (average of 69 CGE). Doses to small regions of the tumor were deliberately reduced where they abutted certain normal tissues (brain stem, spinal cord, optic chiasm, and optic nerves) in order to keep these structures at acceptance dose levels. The first study, CT or MR scan, on which there was evidence of increase in tumor was carefully evaluated and that volume transferred to the CT scan on which the treatment plan had been developed. The 3D dose distribution in the region of recurrence was carefully analyzed and a judgement made as to the most probable cause of recurrence. RESULTS: Approximately one quarter (6 of 26) of the cases failed in the prescribed dose region. More than half (15 of 26) failed in regions where tumor dose was limited by normal tissue constraints. Approximately 10% of the patients recurred in the surgical pathway and 10% were judged to be marginal misses. CONCLUSIONS: Overall, 75% of the patients failed in regions receiving less than the prescribed dose. All tumors which failed in the high dose region had volume greater than 75 cc. Patients with cervical spine disease had a higher rate of recurrence (10 or 26) and larger tumors (average volume of 102 cc) than those with base of skull disease (16 of 115) with an average volume of 63 cc.

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Evidence is presented for the interaction of X irradiation, slightly toxic levels of chloroquine, and mild hyperthermia in the inactivation of colony-forming ability in asynchronous HeLa cells. A three-way interaction was observed which resulted in the potentiation of radiation-induced lethality. There was little evidence of toxicity in unirradiated cells incubated for 3 h with 0.1 mM chloroquine at either 37 or 41 degrees C. The radiopotentiation factor, which is similar to the dose modification factor, was determined from dose-response curves by relating the reciprocal of the slope (D0) of the reference survival curve to that of the survival curve of cells receiving the combined postirradiation treatment with chloroquine and mild hyperthermia. Radiopotentiation factors larger than 1.7 were obtained irrespective of whether the reference D0's were obtained from survival curves for cells irradiated at 37 degrees C without drug or from cells receiving postirradiation treatment with heat or drug only.

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The survival rates of 117 black and white patients treated by primary radiation for carcinoma of the prostate at the State University of New York Health Science Center at Brooklyn and Kings County Hospital Center were analyzed according to age and race. In addition, stage, grade, and delay time in seeking medical attention were analyzed. Survival was similar in both young (less than 60 years) and old (greater than or equal to 60 years) patients, with 45% and 41% 5-year-survival rates, respectively. Survival was better in white patients, 48% 5-year survival, than in blacks, 35% 5-year survival. Black patients presented with higher stage disease than whites (p less than 0.01). This trend was even greater in young black males, who had higher grade (64% versus 11%; p less than 0.04) and higher stage tumors (p less than 0.05). In addition, young blacks delayed seeking medical attention greater than 3 months 72% of the time, as compared to 0% in white young males (p less than 0.005). A survival difference was also seen in young blacks as compared with young whites: 3.9-year median survival versus 6.0-year median survival, respectively.

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The morphology and structural organisation of the complexes formed from the apoprotein of porcine high-density lipoprotein and dimyristoyl phosphatidylcholine (lecithin) have been studied using the technique of small-angle X-ray scattering. Scattering measurements made in solvents of varying electron density were interpreted in terms of a scattering-equivalent model for the structure of the complex. This model is described by an oblate ellipsoidal morphology with dimensions at 20 degrees C: major axis 11.0 nm, minor axis 5.5 nm. Within this overall shape the lipid hydrocarbon chains are organised in an apolar core whilst the lipid polar head groups and protein are located in a outer shell 0.85 nm in thickness. The oblate morphology demonstrates that the structure of the complex is directed by the fundamental bilayer organisation of the lecithin. The dimension of the minor axis (5.5 nm) indicates that phospholipid hydrocarbon chains are orientated perpendicular to the interface.

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The weights of mouse sarcoma 180 differed according to the varieties of mouse. In two varieties in which both sexes were studied the tumour weights were lower in females. In three varieties the tumours weighed less at lower environmental temperatures than at higher ones. At three environmental temperatures in the physiological range the surfaces were cooler than the adjacent skin, and the tissues of tumours were cooler than the surrounding subcutaneous tissues. These differences were greater in cooler than in warmer environments and increased as tumours grew larger. There were no histological changes to account for the different tumour weights at different environmental temperatures and it seems probable that tumours are unable to maintain their temperature and their metabolism in cool environments. In mice of the same breed kept at room temperature the smallest animals had the largest tumours in a weight range of 18-28 g.

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