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Background: Salivary gland lesions are highly heterogenous group of disorder. There are no reliable criteria to differentiate benign from malignant lesions on clinical grounds, so histopathological evaluation is essential. Methods: The present study was retrospective study carried out in the department of pathology, Government medical college, Surat from January 2015 to June 2020. Biopsies/specimens were fixed by 10% neutral buffered formalin and processed, embedded in paraffin and sections were cut and stained with hematoxylin and eosin stain. All the slides were reviewed by authors and re-staining of slides and fresh sections of tissue blocks were performed whenever required. Results: Out of 80 cases, 22 were non-neoplastic, 45 were benign and 13 were malignant. In our study most common non neoplastic lesion was chronic sialadenitis. Most common benign lesion was pleomorphic adenoma. Most common malignant lesion was mucoepidermoid carcinoma. Most commonly involved gland was parotid gland. In parotid gland, most common lesions were benign. The overall sex incidence of salivary gland lesions in male was 45% and 55% in females with a male to female ratio of 1:1.2. Conclusions: Thorough knowledge of morphology of salivary gland lesion is helpful in final diagnosis in predicting prognosis, typing, staging and grading of salivary neoplasms.

Rosai-Dorfman Disease (RDD) is also known as Sinus Histiocytosis of Massive Lymphadenopathy(SHML). Clinically Rosai-Dorfman Disease is characterized by massive, painless, bilateral cervicallymph node enlargement, often mimics lymphoma. Microscopically, it shows dilatation of lymphaticsinuses occupied by numerous lymphocytes and proliferation of histiocytes with abundant paleeosinophilic cytoplasm containing engulfed lymphocytes or plasma cells- emperipolesis.

ObjectivesProgress towards universal health coverage (UHC) requires evidence-based policy including good quality cost data systems. Establishing these systems can be complex, resource-intensive and take time. This study synthesises evidence on the experiences of low-income and middle-income countries (LMICs) in the institutionalisation of cost data systems to derive lessons for the technical process of price-setting in the context of UHC.DesignA scoping review and narrative synthesis of publicly available information.Data sourcesPubMed, MEDLINE, EconLit, the Web of Science and grey literature searched from January 2000 to April 2021.Eligibility criteriaEnglish-language papers published since 2000 that identified and/or described development of and/or methods used to estimate or inform national tariffs for hospital reimbursement in LMICs. Papers were screened by two independent reviewers.Data extraction and synthesisExtraction was performed by one reviewer and checked by the second reviewer on: the method and outputs of cost data collection; commentary on the use of cost data; description of the technical process of tariff setting; and strengths and challenges of the approach. Evidence was summarised using narrative review.ResultsThirty of 484 papers identified were eligible. Fourteen papers reported on primary cost data collection; 18 papers explained how cost evidence informs tariff-setting. Experience was focused in Asia (n=22) with countries at different stages of developing cost systems. Experiences on cost accounting tend to showcase country costing experiences, methods and implementation. There is little documentation how data have been incorporated into decision making and price setting. Where cost information or cost systems have been used, there is improved transparency in decision making alongside increased efficiency.ConclusionsThere are widely used and accepted methods for generating cost information. Countries need to build sustainable cost systems appropriate to their settings and budgets and adopt transparent processes and methodologies for translating costs into prices.

Background Non-pharmaceutical interventions (NPIs) are the cornerstone of infectious disease outbreak response in the absence of effective pharmaceutical interventions. Outbreak strategies often involve combinations of NPIs that may change according to disease prevalence and population response. Little is known with regard to how costly each NPI is to implement. This information is essential to inform policy decisions for outbreak response. Objective To address this gap in existing literature, we conducted a systematic review on outbreak costings and simulation studies related to a number of NPI strategies, including isolating infected individuals, contact tracing and quarantine, and school closures. Methods Our search covered the MEDLINE and EMBASE databases, studies published between 1990 and 24 March 2020 were included. We included studies containing cost data for our NPIs of interest in pandemic, epidemic, and outbreak response scenarios. Results We identified 61 relevant studies. There was substantial heterogeneity in the cost components recorded for NPIs in outbreak costing studies. The direct costs of NPIs for which costing studies existed also ranged widely: isolating infected individuals per case: US$141.18 to US$1042.68 (2020 values), tracing and quarantine of contacts per contact: US$40.73 to US$93.59, social distancing: US$33.76 to US$167.92, personal protection and hygiene: US$0.15 to US$895.60. Conclusion While there are gaps and heterogeneity in available cost data, the findings of this review and the collated cost database serve as an important resource for evidence-based decision-making for estimating costs pertaining to NPI implementation in future outbreak response policies. Supplementary Information The online version contains supplementary material available at 10.1007/s40258-021-00659-z.

BackgroundProgress towards universal health coverage requires evidence based policy and good quality cost data systems. Establishing these systems, can be complex, resource intensive and take time. Synthesising information on the experiences of low-and-middle income countries (LMICs) in trying to institutionalize cost data systems provides lessons for other settings.MethodsWe performed a scoping literature review, screening for publicly available peer-reviewed English-language publications alongside a grey literature search, focussing on national level health system costing in LMICs, and used a narrative synthesis approach to document experience of costing and how costing evidence is used to inform tariffs.ResultsA total of 484 papers were initially identified of which 30 papers were considered eligible. Fourteen papers reported on primary cost data collection for price-setting purposes; 18 papers provided an explanation of how cost evidence informs tariff-setting. Documented experience is largely focussed in the Asia region (n = 22) with countries at different stages of developing cost systems to inform tariff setting. Country experiences on healthcare cost accounting tend to showcase country costing experiences, methods and implementation. There is little documentation of how cost data has been incorporated into decision making and price setting. Where cost data, cost systems and costing has been used, improved transparency in decision making alongside increased service provision efficiency has followed.ConclusionsWhile there are accepted and widely used methods for generating cost information, countries need to build sustainable cost systems appropriate to their settings and budgets and adopt transparent processes and methodologies for translating costs into prices.

In this communication, report of nanostructured polycrystalline La0.7Sr0.3MnO3 (LSMO) prepared through a co-precipitation technique at 800 °C, 900 °C and 1000 °C is discussed in detail. The structural, electrical transport, magnetoresistance and magnetic properties of LSMO samples were found strongly dependent on the sintering temperature (TS). Structural properties were studied through XRD and SEM. The results of Rietveld refined XRD data show that all the samples are in tetragonal arrangement and having single-phase structure with space group I4/mcm (1 4 0). The average size of synthesized nanoparticles was found increasing (21.05 nm to 46.06 nm) with increase in sintering temperature. A significant increase in metal–insulator transition temperature (TMI) was observed at higher sintering temperatures. Higher sintering temperature results in the enhancement of resistivity. To understand the metallic part of resistivity (T

The role of the pathologist in the evaluation of breast cancer now transcends that of determining the correct morphologic diagnosis, including the grading and staging of the cancer. Lumpectomy or modified radical mastectomy is the most commonly used tools for disease management. The objective of this study is to identify the clinical, macroscopic and microscopic examination of breast cancer which evaluates details like age, laterality, tumor size, stage, grade, lympho-vascular invasion and lymph node status. The study comprised a total of 212 breast cancer patients of which 209 were females. The mean age was 51.16 years. Majority of female patients were within age group 41 to 50 years. Left breast was more commonly involved than right breast. Invasive ductal carcinoma was the most common observed histological type of breast carcinoma. Grade II tumors were most frequent followed by Grade III and Grade I. Maximum 125 cases (59%) were 2-5 cm size. Mean size was 4.8 cm. There was increased incidence of Lymphovascular invasion as grade increased. Maximum number of lymphnode involvement was seen in grade II followed by grade III cases. Present study provides significance of various prognostic factors in breast cancer.

Background: Nowadays, vascular disease is the leading cause of death and disability. India too is facing epidemic of cardiovascular and cerebrovascular disease. The established risk factors for heart disease and stroke account for one half to three fourth of cases. The remainders are the result of other factors that promote atherosclerosis. Elevated blood levels of homocysteine have been linked to increased risk of premature coronary artery disease, stroke and thromboembolism, even among people who have normal cholesterol levels. Hence screen for homocysteine is recommended in patients with premature atherosclerotic disease and unexplained venous thrombosis. Methods: The present study was performed to correlate the levels of serum homocysteine levels in young patients (

ObjectivesCritical care is essential in saving lives of critically ill patients, however, provision of critical care across lower resource settings can be costly, fragmented and heterogenous. Despite the urgent need to scale up the provision of critical care, little is known about its availability and cost. Here, we aim to systematically review and identify reported resource use, availability and costs for the provision of critical care and the nature of critical care provision in Tanzania.DesignThis is a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesMedline, Embase and Global Health databases were searched covering the period 2010 to 17 November 2020.Eligibility criteriaWe included studies that reported on forms of critical care offered, critical care services offered and/or costs and resources used in the provision of care in Tanzania published from 2010.Data extraction and synthesisQuality assessment of the articles and data extraction was done by two independent researchers. The Reference Case for Estimating the Costs of Global Health Services and Interventions was used to assess quality of included studies. A narrative synthesis of extracted data was conducted. Costs were adjusted and reported in 2019 US$ and TZS using the World Bank GDP deflators.ResultsA total 31 studies were found to fulfil the inclusion and exclusion criteria. Critical care identified in Tanzania was categorised into: intensive care unit (ICU) delivered critical care and non-ICU critical care. The availability of ICU delivered critical care was limited to urban settings whereas non-ICU critical care was found in rural and urban settings. Paediatric critical care equipment was more scarce than equipment for adults. 15 studies reported on the costs of services related to critical care yet no study reported an average or unit cost of critical care. Costs of medication, equipment (eg, oxygen, personal protective equipment), services and human resources were identified as inputs to specific critical care services in Tanzania.ConclusionThere is limited evidence on the resource use, availability and costs of critical care in Tanzania. There is a strong need for further empirical research on critical care resources availability, utilisation and costs across specialties and hospitals of different level in low/middle-income countries like Tanzania to inform planning, priority setting and budgeting for critical care services.PROSPERO registration numberCRD42020221923.

Background: Cerebro Spinal Fluid (CSF) examination is very useful in patients of suspected CNS disease and the necessity of correlating it with the clinico-pathologic findings which will help in early diagnosis of CNS diseases and guide the further management of the disease. CSF examination with quantification of leukocytes and differential count of cellular subsets in the cerebrospinal fluid is a standard procedure in cases of suspected infectious conditions. Present study emphasises pleocytosis in the cerebrospinal fluid along with other laboratory parameters. Materials and Methods: The study is consisting of 295 CSF samples from patients with clinically suspected CNS infections. The CSF findings were evaluated in all age group patients in relation to cell counts and pleocytosis. Results: In Physical examination of CSF colour, appearance and received quantity were evaluated. Maximum specimen was received in 1 year to 18 year age group. CSF pleocytosis (>5cells/µl) was present maximum (48%) in 1 month to less than 1 year age. Pleocytosis >5 leucocytes/µl was found in 121 (41%) samples out of 295 samples. Conclusion: CSF cell count examination is very common and useful investigation done for suspected various CNS diseases. Infectious and non-infectious diseases of CNS can cause pleocytosis of the cerebrospinal fluid. The type of cells depends mainly on the clinical scenario. However it seems to vary with total cell count also, such as lymphocytes predominating at lower total cell counts while neutrophils are at higher total counts.

In this communication, we report the structural and electrical transport properties of (1-x) La0.7Sr0.3Mn0.95Co0.05O3 (LSMCO) + (x) ZnO (x = 0%, 6%, 9%, 12%, 15% & 18%) composites. For the preparation of (1-x) LSMCO + (x) ZnO (x = 6%, 9%, 12%, 15% & 18%) composites, sample of LSMCO was prepared by the auto combustion technique/inexpensive modified sol-gel technique. The results of Rietveld refined XRD data show that LSMCO sample possesses a rhombohedral structure with the R-3c space group whereas ZnO compound remains with hexagonal structure with the P63mc space group in all the composite samples. The X-ray diffraction (XRD) and scanning electron microscopy (SEM) show that no any extra unwanted phase was observed in each composite excluding the LSMCO and ZnO phases. ZnO is mostly distributed at the grain boundaries and on the surface of the LSMCO grains. Elemental presence and ratio was confirmed through the EDX analysis. The electrical resistivity of LSMCO and each composite was measured in the temperature range of 2 K–320 K at 0 Oe, 10 kOe, 50 kOe & 90 kOe magnetic field. The results indicate that the ZnO addition increases the resistivity of all the composites compare to that of pure LSMCO. The electrical resistivity explored by the theoretical model below TMI and fitting enlightenment for the observed behavior is transmitted here in detail.

Summary box Traditional health technology assessment (HTA) is a policy-based research process, which aims to improve the efficiency and equity of the healthcare system with the limited financial resources available in healthcare.1 In various countries, traditional HTA has been ‘institutionalised’—through the development of dedicated agencies with accepted norms and rules that guide explicit priority setting—over years or decades. These agencies use time-consuming, data intensive and systematic methods and processes which require health economics expertise and resources to make recommendations on how to allocate finite resources.2 There is a growing appetite for HTA and its eventual institutionalisation in low- and-middle income countries (LMICs) driven in part by WHO’s recommendation for it to be a critical component to achieving universal health coverage.3 While there are notable LMIC exceptions of introducing and institutionalising HTA (eg, Thailand, Colombia, Brazil and India), others may be constrained by limited technical and administrative capacity, paucity of data, time and governance structures to carry out HTA.4 A more pragmatic approach …

BACKGROUND The US Preventive Services Task Force (USPSTF) endorses routine screening for genetic risk of breast and/or ovarian cancer as a component of primary health care. Implementation of this recommendation may prove challenging, especially in clinics serving disadvantaged communities. METHODS The authors tested the feasibility of implementing the USPSTF mandate at a federally qualified health center (FQHC) to identify women who were eligible for genetic counseling (GC). A 12-month usual-care phase was followed by a 12-month intervention phase, during which time cancer genetic risk assessment (CGRA) was systematically performed for all women aged 25 to 69 years who presented for an annual examination. Women who were eligible for GC were recruited to participate in the study. RESULTS After initiating CGRA, 112 women who were eligible for GC consented to study participation, and 56% of them received a referral for GC from their primary care physician. A subgroup of 50 participants were seen by the same primary care physician during both the usual-care and intervention phases. None of these patients was referred for GC during usual care, compared with 64% after the initiation of CGRA (P

Importance Black women bear a disproportionate burden of breast cancer mortality in the US, in part due to inequities in the use of mammography. Population screening for breast cancer risk in primary care is a promising strategy for mitigating breast cancer disparities, but it is unknown whether this strategy would be associated with increased mammography rates in underserved women of racial and ethnic minority groups. Objective To examine whether providing individualized breast cancer risk estimates is associated with an increase in the rate of screening mammography. Design, Setting, and Participants A cohort study was conducted in women receiving individualized risk estimates as part of routine primary health care at federally qualified health centers in medically underserved communities in Chicago, Illinois. The study was conducted from November 5, 2013, to December 19, 2014, with data acquisition completed on March 5, 2017; data analysis was performed from December 30, 2020, to February 2, 2021. A total of 347 women aged 25 to 69 years without a personal history of breast cancer presenting for an annual visit with their primary care clinician were enrolled. Exposures Breast cancer risk estimates were obtained with validated risk assessment tools as a standard component of the clinic check-in process. One of 4 women at average risk and all women at high risk were invited to participate in the study. Main Outcomes and Measures The primary outcome was the mammography rate during 18 months of usual care compared with the rate during 18 months after implementation of risk assessment. Results Of the 347 women enrolled, 188 were age-eligible for mammography and were included in the analysis (mean [SD] age, 50.8 [7.04] years); 70 women (37.2%) were Hispanic, 114 (60.6%) were non-Hispanic African American, and 4 (2.1%) were from other racial and ethnic groups (4 non-Hispanic White women). Ninety-eight women (52.1%) had an average risk of developing breast cancer and 90 (47.9%) were at high risk. Overall, there was a nonsignificant increase in the mammography rate, from 38.8% during usual care to 48.9% following implementation of risk assessment (odds ratio, 1.37; 95% CI, 0.92-2.03). In preplanned subgroup analysis, the mammography rate among women at high risk was significantly higher after vs before risk assessment (51.1% vs 36.6%; odds ratio, 1.88; 95% CI, 1.10-3.23). Conclusions and Relevance In this study, providing individualized breast cancer risk estimates as a component of primary health care in federally qualified health centers was associated with increased use of mammography among women of racial and ethnic minority groups who were at high risk. Implementation of this approach in underserved communities could promote equity in the use of mammography and reduce racial disparities in breast cancer mortality. This strategy warrants further investigation.

IntroductionCritical care is essential in saving lives of those that are critically ill, however, provision of critical care can be costly and heterogeneous across lower-resource settings. This paper describes the protocol for a systematic review of the literature that aims to identify the reported costs and resources available for the provision of critical care and the forms of critical care provision in Tanzania.Methods and analysisThe review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three databases (MEDLINE, Embase and Global Health) will be searched to identify articles that report the forms of critical care, resources used in the provision of critical care in Tanzania, their availability and the associated costs. The search strategy will be developed from four key concepts; critical care provision, critical illness, resource use, Tanzania. The articles that fulfil the inclusion and exclusion criteria will be assessed for quality using the Reference Case for Estimating the Costs of Global Health Services and Interventions checklist. The extracted data will be summarised using descriptive statistics including frequencies, mean and median of the quantity and costs of resources used in the components of critical care services, depending on the data availability. This study will be carried out between February and November 2021.Ethics and disseminationThis study is a review of secondary data and ethical clearance was sought from and granted by the Tanzanian National Institute of Medical Research (reference: NIMR/HQ/R.8a/Vol. IX/3537) and London School of Hygiene and Tropical Medicine (ethics ref: 22866). We will publish the review in a peer-reviewed journal as an open access article in addition to presenting the findings at conferences and public scientific gatherings.PROSPERO registration numberThe protocol was registered with PROSPERO; registration number: CRD42020221923.

The Nd1-xPbxMnO3 with x ​≤ ​0.4 compounds have been synthesized by an inexpensive modified sol-gel method. X-ray data were analyzed by using Rietveld refinement. The samples with x ​= ​0.3 & 0.4 show the single-phase nature while the sample with x ​= ​0.1 & 0.2 shows the presence of minor extra developed NdMn2O5 phase with orthorhombic symmetry. Scanning Electron Microscograph shows that slight variation in grain arrangement might be due to the variation of A-site cation (Pb-doping). Elemental presence and ratio were confirmed through the Energy Dispersive X-ray analysis. The magnetic properties were studied by measuring dc magnetization through a vibration sample magnetometer indicate that the appreciable differences between zero-field cooled and field cooled profiles below the ferromagnetic to paramagnetic transition temperature ranging from 78 ​K to 192 ​K with increasing content of Pb doping for all samples. The structural and magnetic properties are discussed in detail in light of the concentration of Pb.

e21567 Background: Merkel Cell Carcinoma (MCC) is a cutaneous malignancy with neuroendocrine differentiation, linked to infection with polyomavirus (MCPyV) in 80% of cases. PD1 inhibitors have recently been approved for this indication with ORR, 33-56%; CR, 11-24%; PFS, about 17 months; OS, about 12 months. Nivolumab was tested in the neoadjuvant setting with similar responses with pathological CR, 47%. Methods: Adjuvant pilot study (NCT03798639) with two immunotherapy regimens administered for one year to patients with completely resected MCC at high risk of recurrence (primary lesion of 2 cm or greater, positive or close margins ( < 2 cm), perineural or lymphovascular invasion, mitotic index ≥ 20 mitotic figures per mm2, lymph node involvement (stage pIIIA or pIIIB) with or without extracapsular extension, or completely resected stage IV disease). Arm 1, nivolumab 480 mg q 4 wks and radiation therapy (RT) 50-60 Gy in 25-30 fractions, per standard of care. Arm 2, nivolumab 240 mg q 2 wks and ipilimumab 1 mg/kg q 6 wks. Primary objective was feasibility and completion of treatment in this population. Safety profile (CTCAE v5.0) and recurrence-free survival (RFS) after 18 months were secondary endpoints. Patients were randomly allocated 1:1. Results: Ten patients were screened from January 2019 until April 2020, when COVID put the study on hold and the sponsor discontinued the free drug supply. Seven were enrolled. Four were allocated to Arm 1 and three to Arm 2. Patient characteristics in Table. All patients have completed treatment and are in follow-up. Arm 1: all four patients completed radiation therapy and immunotherapy with no dose modifications or delays. Arm 2: one patient had nivolumab delayed 2 weeks for cellulitis, and another missed the last four last doses of nivolumab for cholecystitis and pancreatitis requiring surgery, unrelated to the immunotherapy. Adverse events (AE) were as expected. Arm1 caused more grade 2 and 3 AEs then Arm2 (no grade 3). One patient each discontinued treatment, in Arm 1 for progression and Arm 2 for immunotoxicity (temporal arteritis grade 2). One recurrence was observed in Arm 1 and none in Arm 2. Conclusions: The number of patients expected to recur at 1 year is 20%. Our observed data is insufficient to establish efficacy. However with no patient recurring in the ipilimumab arm after 18 months of follow-up and lower observed side effects, we would favor this regimen for the next trial. Clinical trial information: NCT03798639. [Table: see text]

Over 20,000 rabies deaths occur annually in India, representing one-third of global human rabies. The Indian state of Tamil Nadu has pioneered a “One Health” committee to address the challenge of rabies in dogs and humans. Currently, rabies control in Tamil Nadu involves postexposure vaccination of humans after dog bites, whereas potential supplemental approaches include canine vaccination and sterilization. We developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu. Integrating local estimates for canine demography and costs, we predicted the impact of canine vaccination and sterilization on human health outcomes and evaluated cost-effectiveness according to the WHO criteria for India, which correspond to thresholds of $1,582 and $4,746 per disability-adjusted life-years (DALYs) for very cost-effective and cost-effective strategies, respectively. We found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 y, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Through integration over parameter uncertainty, we find that, for a cost-effectiveness threshold above $1,400 per DALY, canine interventions are at least 95% likely to be optimal. If owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective. This case study of cost-effective canine interventions in Tamil Nadu may have applicability to other settings in India and beyond.

Agriculture has been implicated as a potential driver of human infectious diseases. However, the generality of disease-agriculture relationships has not been systematically assessed, hindering efforts to incorporate human health considerations into land-use and development policies. Here we perform a meta-analysis with 34 eligible studies and show that people who live or work in agricultural land in Southeast Asia are on average 1.74 (CI 1.47–2.07) times as likely to be infected with a pathogen than those unexposed. Effect sizes are greatest for exposure to oil palm, rubber, and non-poultry based livestock farming and for hookworm (OR 2.42, CI 1.56–3.75), malaria (OR 2.00, CI 1.46–2.73), scrub typhus (OR 2.37, CI 1.41–3.96) and spotted fever group diseases (OR 3.91, CI 2.61–5.85). In contrast, no change in infection risk is detected for faecal-oral route diseases. Although responses vary by land-use and disease types, results suggest that agricultural land-uses exacerbate many infectious diseases in Southeast Asia., Here, Shah et al. perform a meta-analysis and show that people who live or work in agricultural land in Southeast Asia are on average 1.7 times more likely to be infected with a pathogen than controls, suggesting that agricultural land-use increases infectious disease risk.

Objectives Pazopanib is a multikinase angiogenesis inhibitor. Alisertib is a highly selective inhibitor of mitotic Aurora A kinase. There is preclinical evidence that mitosis-targeting agents exhibit antiangiogenic effects. Thus, the combination of these 2 agents may have a synergistic effect on tumor vasculature. The primary objective of this study is to determine the optimal tolerated dose (OTD) for alisertib and pazopanib. Materials and methods This phase 1b study evaluated the OTD of alisertib twice a day, on days 1 to 7 with pazopanib, once a day, continuously in a 21-day cycle, both taken orally. Disease response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1 every 2 cycles. OTD cohort was expanded to assure safety and perform pharmacokinetics analysis. Results A total of 27 patients received treatment. Seventy-seven percent of the patients had received at least 3 prior chemotherapy regimens. Dose-limiting toxicities occurred in dose level (DL) 2+ (grade 4 thrombocytopenia and grade 3 mucositis) and DL 3 (grade 3 liver transaminases elevation and grade 3 abdominal pain). The OTD was determined to be DL 2: alisertib 20 mg twice daily and pazopanib 600 mg daily. Pharmacokinetic analysis revealed that clearance of alisertib was reduced by ∼40% in the presence of pazopanib compared with clearance in the absence of pazopanib. Fourteen patients had stable disease and 2 patients had a partial response. Conclusions The combination of alisertib with pazopanib demonstrates manageable safety and early clinical evidence of antitumor activity in patients with advanced malignancies (NCT01639911).

The structural, electrical and magnetoresistance properties of Nd1-xPbxMnO3 with x = 0.1, 0.2, 0.3 & 0.4 have been investigated. All the samples were prepared through the modified sol-gel method. X-ray data were analyzed and found that the samples with x = 0.3 & 0.4 show the single-phase nature while the samples with x = 0.1 & 0.2 show the presence of minor extra NdMn2O5 phase with orthorhombic symmetry. Scanning electron microscopy (SEM) shows that the variation of grain growth was found with a change in the concentration of Pb. The temperature-dependent resistivity data shows the metal-insulator transition (TMI) with the higher values of Pb content (x = 0.3 & 0.4) and TMI shifts to higher temperatures with an applied magnetic field (2 T–8 T) excluding the x = 0.1 & 0.2 samples. Resistivity data were explored by the different suitable theoretical models below and above TMI. A very high value of MR (nearly 99.47%) was observed for x = 0.1 at 10 K under the applied magnetic field of 80 kOe. A sample with x = 0.3 also shows a higher MR of about 96.93% at 200 K with the applied magnetic field of 80 kOe.

We have investigated the electrical transport, magnetotransport and magnetic properties of (1-x) La0.7Sr0.3Mn0.94Co0.06O3(LSMCO)/x ZnO (x = 0, 0.04) composite samples to explore the role of the secondary phase. The results of Rietveld refined X-ray diffraction (XRD) data show that the prepared LSMCO sample possesses a rhombohedral structure in the hexagonal lattice and the same reveal that both the compounds in the composite maintain their identities, that is, there is no evidence of reaction between the LSMCO and ZnO. It has been observed that the addition of the ZnO phase into the pure LMSCO sample lowers the metal–insulator transition temperature (TMI). The electrical resistivity was explored by various theoretical models below & above the metal–insulator transition temperature. In the case of a composite sample (x = 0.04), the high field magnetoresistance has been observed at around room temperature. In the magnetic study, the saturation of magnetization decreases in the case of ZnO added LSMCO sample.

The spectrum of histopathological variations of most of the Dermatological conditions is so wide and overlapping that even with our current vast knowledge of this discipline, it seems to be a tough task for clinicians as well as Dermatopathologists to arrive at a conclusive diagnosis in many cases. However, with the aid of special stains and advanced diagnostic techniques, some characteristic histopathologic features have been defined over the time, among which histopathological bodies or inclusion bodies serve as specific clues. With this perspective in view, an attempt has been made to collate and describe the well-known as well as the lesser-known histopathological bodies seen in various dermatological diseases. The underlying pathogenesis and ultramicroscopic features of these structures have also been outlined in brief.

We have investigated the effect of magneto-transport and magnetic properties of (1-x)La0.7Sr0.3Mn0.95Co0.05O3 (LSMCO)+(x)ZnO (x = 0%, 6%, 9%, 12%, 15% & 18%) composite samples which were synthesized through an inexpensive auto combustion technique. The enhancement of MR was observed over a wide temperature range from low temperature to high temperature which is shown in Fig. 1. Magnetic measurements reveal that the ferromagnetic order of LSMCO is weakened and the magnetic disorder is increased by addition of ZnO content. The Curie temperature (TC1) is almost independent on the ZnO content and is about 347 K for both pure LSMCO and each composite while for only ZnO added LSMCO samples, TC2 was observed and TC2 increases with increase in ZnO content which is shown in Fig. 2. M − H curves that for x = 6% and 9% ZnO added composite samples have large saturation magnetization (MS) as compared to pure LSMCO and remaining composites at all temperatures taken.

1554 Background: Medically underserved women bear a disproportionate burden of breast cancer (BC) mortality. Early detection is vital for reducing BC deaths. Cancer genetic risk assessment (CGRA) provides an opportunity to identify women at highest risk so that risk-adapted screening can be implemented. The effect of CGRA on mammography adherence among underserved women is unknown. Methods: We conducted a study to test the feasibility of performing cancer genetic risk assessment (CGRA) as part of standard primary healthcare at two Federally Qualified Health Centers in Chicago, IL. Racial/ethnically diverse women age 25-69 without a personal history of BC underwent CGRA at the time of an annual well-visit and received the result from their PCP. Medical record review provided data on mammography adherence. Demographic data and measures of perceived BC risk, BC cultural beliefs, fatalism, and BC worry were collected with an enrollment survey. McNemar’s test compared the rate of adherence to screening mammography before and after implementation of CGRA, defined as completing a screening mammogram within 18 months prior to or following CGRA, resp., among women eligible for screening (age > 40 at study enrollment). Logistic regression models tested for associations between mammography adherence and demographic characteristics/health beliefs. Results: Data was available for 90 participants with increased BC risk (IR) who were eligible for screening and 98 eligible, average risk (AR) participants (in total, 61% black and 37% Latina). Overall, adherence improved from 38% at baseline to 49% following CGRA (p = 0.03). Adherence increased from 35% to 51% among IR participants (p = 0.04), and from 40% to 47% among AR participants (p = 0.39). Data on predictors of adherence will be presented. Conclusions: Implementing CGRA as a standard component of primary healthcare improved adherence to screening mammography among racial/ethnically diverse underserved women. The effect was seen primarily in those with increased risk. This intervention could be used to improve uptake of mammography in the subgroup of underserved women who benefit the most from screening.

Background: Agricultural land use and land-use change activities are a major contributor to biodiversity loss, pollution, and carbon emissions. Evidence from multiple studies also implicates agricultural activities as a factor underlying a range of human infectious disease risks. However, these links have not been systematically assessed or quantified, hindering efforts to incorporate human health effects into land-use decision and policy making. In this study, we test and quantify the association between exposure to agricultural land use and human infectious disease risks, focusing on the highly diverse yet tractable example of southeast Asia. Methods: We systematically reviewed English peer-reviewed publications from PubMed, EMBASE, Medline, Global Health, Google Scholar, and Web of Science databases between April 24, and Sept 10, 2017. Only studies done in southeast Asia testing the association between land use or changes in land use and infectious disease prevalence or incidence in human beings were included. We extracted crude and adjusted odds ratios (ORs) from the original studies, and for studies that did not present ORs, we calculated crude ORs provided sufficient data were available. We did a meta-analysis with mutually exclusive estimates using a random effects logistic regression model, with heterogeneity of effects addressed using prespecified subgroup analysis, the I2 test for heterogeneity and the Cochrane Q test. We assessed publication bias using funnel plots, a linear regression test, and the trim and fill method, and explored the effect of potential unmeasured confounders with an E-value analysis. The primary outcome was risk of infection in people who worked in agriculture or lived in an agricultural setting. Findings: Of 15 476 unique citations generated from our literature search, 37 articles were included in our meta-analysis. Our results showed that people who live or work in or near agricultural land are more likely to be infected with a pathogen than controls (OR 1·54, 95% CI 1·30–1·83, p