Background:Human papillomavirus (HPV)-positive oropharyngeal cancer (OPSCC) is associated with improved survival compared with HPV-negative disease. However, a minority of HPV-positive patients have poor prognosis. Currently, there is no generally accepted strategy for identifying these patients.Methods:We retrospectively analysed 270 consecutively treated OPSCC patients from three centres for effects of clinical, pathological, immunological, and molecular features on disease mortality. We used Cox regression to examine associations between factors and OPSCC death, and developed a prognostic model for 3-year mortality using logistic regression analysis.Results:Patients with HPV-positive tumours showed improved survival (hazard ratio (HR), 0.33 (0.21–0.53)). High levels of tumour-infiltrating lymphocytes (TILs) stratified HPV-positive patients into high-risk and low-risk groups (3-year survival; HPV-positive/TILhigh=96%, HPV-positive/TILlow=59%). Survival of HPV-positive/TILlow patients did not differ from HPV-negative patients (HR, 1.01; P=0.98). We developed a prognostic model for HPV-positive tumours using a ‘training' cohort from one centre; the combination of TIL levels, heavy smoking, and T-stage were significant (AUROC=0·87). This model was validated on patients from the other centres (detection rate 67% false-positive rate 5.6% AUROC=0·82).Interpretation:Our data suggest that an immune response, reflected by TIL levels in the primary tumour, has an important role in the improved survival seen in most HPV-positive patients, and is relevant for the clinical evaluation of HPV-positive OPSCC.

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Objectives:The objective of this study is to assess the prevalence of sexual violence, stalking, and intimate partner violence (IPV) across sexual orientation groups among U.S. adults. Method:From 2010 to 2012, national probability samples (n = 41,174) of English-or Spanishspeaking noninstitutionalized U.S. adults were interviewed to assess the prevalence of violence and injury as part of the National Intimate Partner and Sexual Violence Survey. National estimates across sexual orientation groups were compared.Results: Compared with heterosexual women, both bisexual women and lesbians experienced more contact sexual violence (CSV) and noncontact unwanted sexual violence by any perpetrator. In addition, bisexual women experienced more stalking by any perpetrator, IPV, and IPV-related impact than did heterosexual women. Compared with lesbians, bisexual women reported more CSV and stalking by any perpetrator, IPV, and IPV-related impact. Compared with heterosexual men, both bisexual and gay men experienced more CSV and noncontact unwanted sexual violence, and gay men experienced more stalking. Although there were no detected statistically

Suicide is a major public health problem with B1 million victims each year worldwide. Up to 90% of adults who commit suicide have at least one psychiatric diagnosis such as major depression, bipolar disorder (BPD), schizophrenia (SZ), substance abuse or dependence. A question that has remained unanswered is whether the biological substrates of suicide are distinct from those of the psychiatric disorders in which it occurs. The serotonin 2C receptor (5-HT 2C R) has been implicated in depression and suicide. We, therefore, compared the frequencies of its mRNA editing variants in postmortem prefrontal cortical specimens from subjects who committed suicide or who died from other causes. All suicides occurred in the context of either SZ or BPD. The non-suicide cases included subjects with either SZ or BPD as well as subjects with no psychiatric diagnosis. We identified 5-HT 2C R mRNA editing variations that were associated with suicide but not with the comorbid psychiatric diagnoses, and were not influenced by demographic characteristics (age and sex) and alcohol or drug use. These variations consisted of a significant increase in the pool of mRNA variants (ACD and ABCD) that encode one of the most prevalent and highly edited isoforms of 5-HT 2C R, that is, VSV (Val156-Ser158-Val160). Because the VSV isoform of 5-HT 2C R exhibits low functional activity, an increase in its expression frequency may significantly influence the serotonergic regulation of the brain. Thus, at least in patients with SZ or BPD, overexpression of the VSV isoform in the prefrontal cortex may represent an additional risk factor for suicidal behavior.

Background Oropharyngeal squamous cell carcinoma (SCC) is staged using the TNM system. Human papillomavirus (HPV)‐positive tumors have improved prognosis, despite presenting at advanced stage. Optimal treatment and stratification of HPV‐positive patients are not clearly defined. Methods We retrospectively analyzed 266 patients with oropharyngeal SCC for mortality and feeding tube dependency related to TNM stage, HPV status, and treatment. Results TNM staging was prognostic in HPV‐negative patients (stage III/IV hazard ratio [HR], 2.00; p = .05; N+ HR, 2.19; p = .02). Only T classification was prognostic in HPV‐positive tumors (T3/T4 HR 3.31; p = .006). HPV‐positive tumors showed improved survival regardless of treatment. Patients receiving chemotherapy had a significantly increased risk of feeding tube dependency (odds ratio [OR], 1.72; p = .03). Conclusion These data suggest that the current TNM system has little prognostic value in HPV‐positive oropharyngeal SCC. Patients with HPV‐positive tumors show improved survival independent of treatment. The addition of chemotherapy increases the risk of feeding tube dependency and could potentially be avoided in T1/T2 HPV‐positive tumors without compromising survival. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1002–1013, 2015