bluuebunny/crossref_metadata_2025 huggingface dataset:
HPB P23 Laparoscopic lumen-guided cholecystectomy in face of the difficult gallbladder
Authors: Lucocq James , Taylor Aaron , Driscoll Peter , Naqvi Syed , MacMillan Alasdair , Bennett Stephen , Luhmann Andreas , Robertson Andrew
Published: December 2022

Background

Where the critical view of safety cannot be established during cholecystectomy, certain salvage techniques are indicated to reduce the likelihood of bile duct injury. The present study describes a salvage technique termed the “laparoscopic lumen-guided cholecystectomy” (LLC) and reports its peri-operative outcomes.

Methods

A summary of the technique is as follows: (1) Hartmann's pouch is incised and stones are evacuated; (2) the cystic anatomy is inspected from the inside of the gallbladder; (3) the lumen is used to guide retrograde dissection towards the cystic pedicle; (4) cystic duct control is achieved if deemed safe. LLC cases performed between June 2020 and January 2022 in a single health board were included. The operative details and peri-operative outcomes of the technique are reported and compared to cases of similar difficulty (Nassar ≥4) where the LLC was not attempted.

Results

LLC was performed in 4.6% (27/587) of cases. In all 27 cases, LLC was performed for a “frozen” cholecystohepatic triangle. Hartmann's pouch was completely excised in all cases (27/27) and cystic duct control was achieved in 85.2% of cases (23/27). No cases of bile leak or ductal injury were reported. Rates of bile leak, post-operative complications and ERCP were lower following LLC compared to the group where LLC was not attempted (p<0.01).

Conclusions

LLC is a safe salvage technique and should be considered in cases where the critical view of safety cannot be established. The technique achieves cystic duct control in the majority of cases and favourable outcomes in the face of a difficult cholecystectomy.
OGC P01 Cost utility analysis of a prehabilitation programme in patients undergoing treatment for oesophageal cancer
Authors: Powell Arfon , Allen Sophie , Casey Patrick , Hunt Julie , Prabhu Pradeep , Jack Sandy , Rockall Timothy , Preston Shaun , Sultan Javed
Published: December 2022

Background

Treatment of oesophageal cancer is associated with significant morbidity which has an impact on longer term survival. Prehabilitation has been shown to reduce post-operative morbidity and mortality. The aim of this study was to undertake a cost-utility analysis to determine if, based on quality adjusted life-years, prehabilitation should be universally implemented in patients undergoing treatment for oesophageal cancer.

Methods

Patients with oesophageal cancer who were recruited to a randomised control trial were retrospectively analysed. Three-years follow-up was available for calculating overall survival. Costs were calculated based on network, staging, and treatment algorithms. QALYs were calculated as a matrix cost of treatment, quality of life, and overall survival. Overall survival was calculated from time of diagnosis to death or censorship at three-years follow up.

Results

Thirty-nine patients were randomised to prehabilitation (n=20, 51%) or standard care (n=19, 49%). The median cost per patient for treatment was £46,770.16 (Inter quartile range (IQR) 41,907.21–58,984.21). The overall cost per patient in the prehabilitation group was lower, £44,382.99 (IQR 42,022.86–54,068.23), when compared with standard care per patient £51,538.07 (IQR41,907.21–68,734.33). The mean survival was 24.7 months in the prehab group compared with 27.7 months in the control group (p=0.523). The cost per-QALY for the prehabilitation group was £24,899.06 compared with £25,781.71 in the standard care group.

Conclusions

In the setting of a randomised control trial, prehabilitation is clinically effective with observed reductions in total treatment costs and a cheaper cost per QALY.
OGC P19 The future insights of evaluating the circumferential resection margin (CRM) status in oesophageal cancer: A 12-year cohort study
Authors: Elshaer Ahmed , Jones Sian , Hayden Jeremy , Mehta Samir , Cockbain A J , Sarela Abeezar , Dexter Simon , Grabsch Heike
Published: December 2022

Background

The definition of CRM (circumferential resection margins) for oesophageal cancers varies among the international pathological bodies with an ongoing controversy about the optimal definition. There is also no enough data about the prognostic relevance of different sites in CRM. In this study, we examined the prognostic impacts of different CRM distances and sites.

Methods

This study included patients who had curative oesophagectomy for oesophageal cancer between 2010 till June 2021. Follow up till April 2022 was achieved. CRM status was carefully examined for the distance and site of involved tumour cells. Patients with involved proximal or distal margins were excluded. The outcomes between different CRM margins were retrospectively analysed. The long-term follow up data was obtained via direct contact with the patients during our oncological clinics, cross-checked with our hospital/national patients’ electronic databases.

Results

456 patients were included in this study. Involved tumour cells within 1mm of CRM was observed in 192 patients (42.1%). CRM+ (<1mm) was associated with worse overall (OS) and disease-free survival (DFS) (22.8 and 16.3 months respectively) compared to CRM-negative (47.7 and 45.1 months respectively), (p-value <0.001 for both). CRM+ (0mm) had worse OS and DFS (20.5 and 12 months respectively) compared to CRM+(0.1–1mm) (26.4 and 20 months respectively), (p-values 0.028 and 0.006 respectively). CRM-positive posterior margin was the most common involved site (32%), but was associated with better OS and DFS compared to anterior and lateral sites, (p-values 0.1 and 0.08 respectively).

Conclusions

The site and distance of tumour cells within CRM should be rigorously assessed in oesophagectomy specimens. The presence of tumour cells within 1mm of CRM was an independent factor for OS and DFS. The CRM+(0 mm) had significant lower survival rates compared to other CRM+ distances (0.1–1 mm). The involved margin sites within CRM had different survival rates, with superiority towards posterior resection margins.
OGC P28 Raman Needle Probe Lymph Node Assessment for Oesophageal Cancer: The DOLOMITE Study
Authors: Ireland Philip , Old Oliver , Hornby Steve , Kendall Catherine , Barr Hugh , Shore Angela , Stone Nick
Published: December 2022

Background

Oesophageal cancer (OC) accounts for 3% of all new cancer diagnosis in the UK. Presentation is often late, reflected in a poor 5-year survival rate of 12%. The importance of identifying lymph node (LN) metastases has been demonstrated as the single biggest prognostic factor.

The current ‘gold standard’ diagnosis of LN metastases is from histopathological assessment of the tissue after surgical resection of the primary tumour and surrounding tissue. The use of imaging techniques to try and gain this information preoperatively is standard practice but far from perfect.

Raman spectroscopy (RS) has been investigated as a diagnostic tool to detect cancer and pre-cancerous change in the oesophagus, and preliminary work demonstrating the application of vibrational spectroscopy (Raman and FTIR) to LN analysis has been undertaken. The development of Raman needle probes (RNP) with potential for use in-vivo furthers the clinical impact.

The DOLOMITE study started recruitment in the summer of 2022 to investigate the ability of RNP to identify the presence of malignant deposits in resected lymph nodes.

Methods

Patients identified by the clinical team as needing oesophagectomy to treat their OC were invited to participate in the study. After the specimen has been resected, prior to formalin fixation, three lymph nodes are dissected representing gastric, para-oesophageal and sub-carinal nodes. These are bisected longitudinally with half remaining with the specimen. The half for research is snap frozen in liquid nitrogen until needed for analysis.

Adjacent sections are cut from the nodes to create slides for Raman mapping and conventional H&E staining. The bulk node left is used for Raman probe analysis. Spectral data is then analysed using MATlab.

Results

At this early stage, our initial measurements have provided information used for calibration in advance of completing recruitment. The Raman mapping has been assessed for correlation with the pathology identified in the H&E slides taken from the lymph node block. This data in turn has provided the background for developing interpretation of the Raman probe data, with further samples we will use this to create a classification model.

Conclusions

With ongoing recruitment the study will be able to fully report by September 2023.

References

1. Stone N, Kendall C, Shepherd N, Crow P, Barr H Near-infrared Raman spectroscopy for the classification of epithelial pre-cancers and cancers 2002 33(7):564–573

2. Kong K, Kendall C, Stone N, Notingher I. Raman spectroscopy for medical diagnostics--From in-vitro biofluid assays to in-vivo cancer detection. Adv Drug Deliv Rev. 2015;89:121–34.
OGC P29 Influence of COVID-19 lockdown and socioeconomic deprivation on the outcomes of gastric cancer - A National study
Authors: Khan Khurram , Baxter Mark , Gall Lewis , Samuelson Catherine , Narramneni Lakshmi , Al-Zuabi Manaf , Bryce Gavin , Shareef Hala , Petty Russell , Forshaw Matthew
Published: December 2022

Background

COVID-19 has significantly disrupted cancer care. This has impacted on staging, management and survival of gastric cancer as health services worldwide had to adapt. Responding to the pandemic, the UK government declared a national lockdown on 23 March 2020. Our aim was to determine the impact of COVID-19 and socio-economic deprivation on patients with newly diagnosed gastric cancers.

Methods

This was a retrospective cohort study. Consecutive new patients presenting in NHS Scotland to five regional OG cancer MDTs covering 93.2% of the Scottish population between October 2019 and September 2020 were identified. Gastric cancers were included and electronic health records were reviewed. Patient's residential address was used to calculate Scottish Index of Multiple Deprivation (SIMD). Patients were divided into two groups: most deprived (SIMD 1–5) and least deprived (SIMD 6–10) and results compared. The study period was divided into pre- and post-lockdown, based on the first UK national lockdown of 23 March 2020.

Results

269 patients were diagnosed with gastric cancer; 4 (1.5%) were excluded due to unrecognised postcode. 173 (65.3%) were male and the median age was 73 years (range 29–94). 143 (54.0%) were in most deprived and 122 (46.0%) were in least deprived group.

Deprivation and lockdown: Age, sex, ECOG performance status and route of referral were not significantly different. No clinically meaningful difference in median time to gastroscopy was observed (16.5 vs 17 days). Stage 4 cancer were more commonly observed in most deprived group (60.8% vs 52.1%).

In whole cohort, the palliative care intent was higher post-lockdown (70% vs 83.2%, p=0.033). Palliative intent treatment increased in the most deprived group from 74.3% to 81.2% and in least deprived from 65.2% to 85.7% (p=0.092).

The median survival for the whole cohort decreased post-lockdown (9.0 vs 6.9 months, p=0.14), but did not reach statistical significance. The medial survival did not change for the most deprived group (7.6 vs 7.1 months, p=0.840), however it decreased significantly for the least deprived group post-lockdown (11 vs 6.7 months, p=0.014).

A test of heterogeneity between lockdown period and SIMD group supported the suggestion that the least deprived cohort did worse post-lockdown (HR 1.72, p=0.055).

Conclusions

This national study highlights that the least deprived patients had survival advantage pre-lockdown, which has been completely lost post COVID-19 national lockdown. This disproportional impact on the least deprived patients could be because early cancers were not diagnosed in the least deprived population.
OGC P46 Positive Circumferential margins are associated with poorer survival following surgery in gastro-oesophageal junctional cancers
Authors: Almonib Ahmed , Tan Benjamin , Siddaiah-Subramanya Manjunath , Ghoneim Abdulrahamn
Published: December 2022

Background

Adenocarcinoma of the gastro-oesophageal junction (GOJ) remains a significant clinical problem that is increasing in incidence and is associated with a poor prognosis. The aim of this study is to determine the effects of the resection margins on survival and recurrence.

Methods

A retrospective study was conducted at our hospital from March 2001 till December 2022. All the patients that had oesophagectomy for gastro-oesophageal junctional (GOJ) adenocarcinoma were included in this study. Demography, staging, margins, type of neo-adjuvant chemotherapy and survival data were collected.

Results

Over the study, 174 patients had Gastro-oesophageal junctional adenocarcinoma.

42 of the patients had circumferential margins positive and 132 had negative circumferential margins.

The median for survival is 18 months in circumferential margins positive and 31 months for the circumferential negative patients with a P value of <0.001

There were no patients with longitudinal margins positive enough to calculate any statical analysis

The median of recurrence is 13.4 months for the circumferential margins positive and 26.8 months for the circumferential margins negative patients with a P value on 0.003

Conclusions

The presence of any circumferential margin tumour will significantly affect the survival rate and recurrence rate.
Media Coverage of Child Welfare Social Workers and its Effect on Professional Self-Esteem: The Moderating Role of Family and Social Support
Authors: Levin Keini Noga , Ben Shlomo Shirley , Shoval Revital , Ramon Dan
Published: December 2022

Negative coverage in the media of social workers employed in the field of child welfare frequently appears in the wake of tragedies within families. Though social workers cannot always prevent incidents of this kind, the media, and consequently the public, blame them for dereliction of duty, an attitude that can affect their professional self-esteem. The present research poses the question of how negative versus positive media coverage of social workers in the field of child welfare affects their professional self-esteem, and whether family and social support can moderate such an outcome. In order to examine this question, a controlled empirical study was carried out with ninety-nine social workers. The participants were divided randomly into three groups, each exposed to media coverage of a different nature: positive, negative and neutral. They were then asked to complete a professional self-esteem questionnaire. The results point to a significant relationship between education, professional seniority, family and social support and professional self-esteem. Thus it was found that family and social support moderated the effects of negative media coverage on professional self-esteem. The implications of the findings for the professional practice of social workers are discussed.
The PSEN1 E280G mutation leads to increased amyloid-β43 production in induced pluripotent stem cell neurons and deposition in brain tissue
Authors: Willumsen Nanet , Arber Charles , Lovejoy Christopher , Toombs Jamie , Alatza Argyro , Weston Philip S J , Chávez-Gutiérrez Lucia , Hardy John , Zetterberg Henrik , Fox Nick C , Ryan Natalie S , Lashley Tammaryn , Wray Selina
Published: December 2022

Mutations in the presenilin 1 gene, PSEN1, which cause familial Alzheimer’s disease alter the processing of amyloid precursor protein, leading to the generation of various amyloid-β peptide species. These species differ in their potential for aggregation. Mutation-specific amyloid-β peptide profiles may thereby influence pathogenicity and clinical heterogeneity. There is particular interest in comparing mutations with typical and atypical clinical presentations, such as E280G. We generated PSEN1 E280G mutation induced pluripotent stem cells from two patients and differentiated them into cortical neurons, along with previously reported PSEN1 M146I, PSEN1 R278I and two control lines. We assessed both the amyloid-β peptide profiles and presenilin 1 protein maturity. We also compared amyloid-β peptide profiles in human post-mortem brain tissue from cases with matched mutations. Amyloid-β ratios significantly differed compared with controls and between different patients, implicating mutation-specific alterations in amyloid-β ratios. Amyloid-β42:40 was increased in the M146I and both E280G lines compared with controls. Amyloid-β42:40 was not increased in the R278I line compared with controls. The amyloid-β43:40 ratio was increased in R278I and both E280G lines compared with controls, but not in M146I cells. Distinct amyloid-β peptide patterns were also observed in human brain tissue from individuals with these mutations, showing some similar patterns to cell line observations. Reduced presenilin 1 maturation was observed in neurons with the PSEN1 R278I and E280G mutations, but not the M146I mutation. These results suggest that mutation location can differentially alter the presenilin 1 protein and affect its autoendoproteolysis and processivity, contributing to the pathological phenotype. Investigating differences in underlying molecular mechanisms of familial Alzheimer’s disease may inform our understanding of clinical heterogeneity.
Comparison of Levels of Nasal, Salivary, and Plasma Antibody to Severe Acute Respiratory Syndrome Coronavirus 2 During Natural Infection and After Vaccination
Authors: Cohen Jeffrey I , Dropulic Lesia , Wang Kening , Gangler Krista , Morgan Kayla , Liepshutz Kelly , Krogmann Tammy , Ali Mir A , Qin Jing , Wang Jing , Vogel Joshua S , Lei Yona , Suzuki-Williams Lui P , Spalding Chris , Palmore Tara N , Burbelo Peter D
Published: December 2022

Background

Most studies of immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) measure antibody or cellular responses in blood; however, the virus infects mucosal surfaces in the nose and conjunctivae and infectious virus is rarely if ever present in the blood.

Methods

We used luciferase immunoprecipitation assays to measure SARS-CoV-2 antibody levels in the plasma, nose, and saliva of infected persons and vaccine recipients. These assays measure antibody that can precipitate the SAR-CoV-2 spike and nucleocapsid proteins.

Results

Levels of plasma anti-spike antibody declined less rapidly than levels of anti-nucleocapsid antibody in infected persons. SARS-CoV-2 anti-spike antibody levels in the nose declined more rapidly than antibody levels in the blood after vaccination of infected persons. Vaccination of previously infected persons boosted anti-spike antibody in plasma more than in the nose or saliva. Nasal and saliva anti-spike antibody levels were significantly correlated with plasma antibody in infected persons who had not been vaccinated and after vaccination of uninfected persons.

Conclusions

Persistently elevated SARS-CoV-2 antibody in plasma may not indicate persistence of antibody at mucosal sites such as the nose. The strong correlation of SARS-CoV-2 antibody in the nose and saliva with that in the blood suggests that mucosal antibodies are derived primarily from transudation from the blood rather than local production. While SARS-CoV-2 vaccine given peripherally boosted mucosal immune responses in infected persons, the increase in antibody titers was higher in plasma than at mucosal sites. Taken together, these observations indicate the need for development of mucosal vaccines to induce potent immune responses at sites where SARS-CoV-2 infection occurs.

Clinical Trials Registration

NCT01306084.
Crohn-like Disease Affecting Small Bowel Due to Monogenic SLCO2A1 Mutations: First Cases of Chronic Enteropathy Associated with SLCO2A1 Gene [CEAS] in France
Authors: Hamon Annick , Cazals-Hatem Dominique , Stefanescu Carmen , Uzzan Mathieu , Treton Xavier , Sauvanet Alain , Panis Yves , Monsinjon Marie , Bonvalet Fanny , Corcos Olivier , Azouguene Emilie , Cerf-Bensussan Nadine , Bouhnik Yoram , Charbit-Henrion Fabienne
Published: December 2022

Introduction

Multiple chronic ulcers of small intestine are mainly ascribed to Crohn’s disease. Among possible differential diagnoses are chronic ulcers of small bowel caused by abnormal activation of the prostaglandin pathway either in the archetypal but uncommon non-steroidal anti-inflammatory drug [NSAID]-induced enteropathy, or in rare monogenic disorders due to PLA2G4A and SLCO2A1 mutations. SLCO2A1 variants are responsible for CEAS [chronic enteropathy associated with SLCO2A1], a syndrome which was exclusively reported in patients of Asian origin. Herein, we report the case of two French female siblings, P1 and P2, with CEAS.

Case report

P1 underwent iterative bowel resections [removing 1 m of small bowel in total] for recurrent strictures and perforations. Her sister P2 had a tight duodenal stricture which required partial duodenectomy. Next-generation sequencing was performed on P1’s DNA and identified two compound heterozygous variants in exon 12 in SLCO2A1, which were also present in P2.

Conclusion

CEAS can be detected within the European population and raises the question of its incidence and recognition outside Asia. Presence of intractable recurrent ulcerations of the small intestine, mimicking Crohn’s disease with concentric strictures, should motivate a genetic search for SLCO2A1 mutations, particularly in the context of family history or consanguinity.
Longitudinal morphological changes of the aorta and the endograft position before and after distal stent graft-induced new entry in aortic dissections
Authors: Andic Mateja , Mustafi Migdat , Bonorden Constantin , Grözinger Gerd , Artzner Christoph , Schlensak Christian , Lescan Mario
Published: December 2022

OBJECTIVES

The aim of this study was to assess the endograft position and aortic geometry changes after thoracic endovascular aortic repair (TEVAR) and frozen elephant trunk (FET) in distal stent-induced new entry (dSINE) patients.

METHODS

In this retrospective cohort study, the baseline demographic and the follow-up data were extracted from the hospital records, and computed tomography scans of dSINE patients after TEVAR or FET between 2011 and 2021 were analysed regarding endograft oversizing, length and migration, taper ratio, aortic diameter at the endograft end, aortic elongation (thoracic inner and outer curvature), wedge apposition angle and tortuosity angle in the distal landing zone.

RESULTS

dSINE was found in 22/213 (10%) of TEVAR and 10/31 (32%) of FET patients. The total follow-up time was 45 (27; 59) months. TEVAR was mainly performed with Relay NBS endograft (77%) and FET with Evita open prosthesis (80%). Paraplegia and stroke rates were 3%. dSINE occurred 17 (7; 35) months post-TEVAR and was instantly treated in 18 patients (56%) or followed up for 21 (11; 34) months (n = 14). Migration [+5 mm (1; 11; P < 0.001)], birdbeak angle [+9° (0; 27; P = 0.039)] and aortic diameter +5 mm (1; 11; P < 0.001) increased after dSINE, whereas aortic elongation increased already before [+12 mm (0; 27; P = 0.015)] and peaked after dSINE [+30 mm (9; 38; P < 0.001)]. The aortic elongation was more pronounced in the outer aortic curvature before and after dSINE (before: P = 0.039, after: P = 0.024). Postoperative wedge apposition [17° (12; 20)] increased before dSINE [21° (16; 35; P < 0.001)] and peaked thereafter [31° (21; 40; P < 0.001)].

CONCLUSIONS

Aortic elongation may influence the endograft position and provoke TEVAR failure in the distal and proximal landing zones.
Modern outcomes of heart-lung transplantation: assessing the impact of the updated US allocation system
Authors: Shin Max , Iyengar Amit , Helmers Mark R , Kelly John J , Song Cindy , Rekhtman David , Cevasco Marisa
Published: December 2022

OBJECTIVES

In 2018, the United Network for Organ Sharing modified their heart allocation policy to reduce waitlist mortality and prioritize patients with the greatest acuity. Considering declining rates of combined heart-lung transplantation, this study sought to investigate the impact of the new allocation system on waitlist and post-transplant outcomes of patients listed for combined heart-lung transplantation.

METHODS

Adult patients listed for combined heart-lung transplant between 2012 and 2021 were included. Patients were stratified according to listing era. Competing risk regression was used to assess waitlist outcomes. Cox proportional hazards regression was used to establish risk factors for post-transplant mortality.

RESULTS

A total of 511 patients were included, of whom 295 (57.8%) were listed in era 1 and 216 (42.2%) in era 2. Era 2 was associated with increased likelihood of transplant (adjusted standard hazard ratio (aSHR): 1.60 [1.23–2.07]; P < 0.01) and decreased waitlist mortality (aSHR: 0.43 [0.25–0.73]; P < 0.01). Despite longer ischaemic times and increased use of preoperative veno-arterial extracorporeal membrane oxygenation (ECMO) in era 2, early post-transplant survival was equivalent. Predicted heart mass ratio <0.8 (Hazard ratio (HR); 3.24; P = 0.01), ventilator support (HR: 3.83; P < 0.01) and greater ischaemic times (HR: 1.80; P < 0.01) independently predicted the mortality. Procedures at high centre volumes (HR: 0.36; P = 0.04) were associated with decreased mortality. Use of ECMO was not predictive of mortality in the modern era.

CONCLUSIONS

The allocation policy change has led to improvements in waitlist outcomes in patients listed for heart-lung transplantation. Despite increased ischaemic times and use of ECMO, early post-transplant survival was equivalent.
Current outcomes of live-born children with double outlet right ventricle in Norway
Authors: Holten-Andersen Mads , Lippert Matthias , Holmstrøm Henrik , Brun Henrik , Døhlen Gaute
Published: December 2022

OBJECTIVES

This population-based, comprehensive, retrospective study presented the clinical outcomes of all children born in Norway between 2003 and 2017 with double outlet right ventricle (DORV).

METHODS

All children born with DORV between 2003 and 2017 were identified in the Oslo University Hospital registry. Patients’ characteristics, interventions, complications and deaths were recorded. Echocardiographic data were reviewed for classification according to current standards. We investigated time-dependent surgical reintervention and mortality using Kaplan–Meier analyses and determinants of treatment complications, reintervention and death using regression analyses.

RESULTS

Ninety-three children with DORV represented an annual median prevalence of 1.18 per 10 000 births in Norway. Six children received palliative care. With an intention to treat, a surgical route with the primary biventricular repair was followed for 62 children, staged biventricular repair for 15 and univentricular repair for 10 children. Major complications occurred in 1.0% and 6.2% of children following catheter or surgical intervention, respectively. No significant determinants of the complications were identified. Overall survival following treatment was 91.9%, 90.8%, 89.5% and 89.5% and corresponding freedom from surgical reintervention was 88.0%, 79.0%, 74.9% and 69.4% at 1, 2, 5 and 10 years, respectively. The presence of atrioventricular septal defect predicted an increased risk of mortality (hazard ratio: 7.16) but did not increase the risk of surgical reintervention.

CONCLUSIONS

In Norway, most children receive tailored treatment for DORV with low rates of complications, surgical reinterventions and mortality. However, atrioventricular septal defect remains a potential determinant of postoperative death.
Gendered parenthood gaps in employer-provided training: the role of immediate supervisors
Authors: Peters Eileen , Cooke Lynn Prince , Melzer Silvia Maja
Published: December 2022

Powerful male actors are argued to secure workplace resources for themselves and other in-group members, contributing to workplace inequalities. We contend that, like gender, parenthood similarity in supervisor–supervisee dyads also provokes group processes, and that parenthood is superordinate to childlessness. Critically, we hypothesize how shared supervisor–supervisee parental status at its intersection with gender might intensify or offset (dis)advantage in access to workplace training. Hypotheses are tested with unique linked German employer–employee data and estimating gender-parental training differences using workplace fixed-effects regressions. Results show that while on average women train less than men and parents train more than childless workers, these effects can alter at the intersection with supervisors’ group memberships. Dyad ‘double jeopardy’ is evident in that childless women face the greatest training disadvantages when reporting to childless female supervisors. Yet whether sharing one superordinate status offsets disadvantage of a subordinate group membership occurs only for shared parenthood. Childless men gain no advantage when reporting to a male supervisor, whereas sharing parenthood with immediate supervisors countervails disadvantage of being female for mother supervisees. We conclude that only by considering social relations at the intersection of supervisor–supervisees’ multiple categorical memberships might we better understand the relational processes sustaining or reducing workplace inequalities.
Glycosylated proteins in the protozoan algaEuglena gracilis: a proteomic approach
Authors: O’Neill Ellis C
Published: December 2022

Protein glycosylation, and in particular N-linked glycans, is a hallmark of eukaryotic cells and has been well-studied in mammalian cells and parasites. However, little research has been conducted to investigate the conservation and variation of protein glycosylation pathways in other eukaryotic organisms. Euglena gracilis is an industrially important microalga, used in the production of biofuels and nutritional supplements. It is evolutionarily highly divergent from green algae and more related to kinetoplastid pathogens. It was recently shown that E. gracilis possesses the machinery for producing a range of protein glycosylations and make simple N-glycans, but the modified proteins were not identified. This study identifies the glycosylated proteins, including transporters, extracellular proteases, and those involved in cell surface signalling. Notably, many of the most highly expressed and glycosylated proteins are not related to any known sequences and are, therefore, likely to be involved in important novel functions in Euglena.
Carrying the Earth to the Sky: Claire Denis’s Perverse Ecologies
Authors: Taylor McNeil
Published: December 2022

Claire Denis and Gilles Deleuze have initiated some of the most radical questioning of the human figure in recent French culture. This tendency has escalated in recent years, as Denis turns her gaze towards interstellar matter in
High Life
(2018), while a growing trend within Deleuze studies has developed the idea of a ‘dark Deleuze’ intent on leaving behind the human once and for all. This article takes these developments as an occasion to broach ethical questions about the implications of Denis and Deleuze’s non-anthropocentric perspective: what happens to relations between humans in a world of heightened non-human animacy? By reading
High Life
alongside a key text for this ‘dark Deleuze’, ‘Michel Tournier et le monde sans autrui’ (1967), I demonstrate how Denis and Deleuze’s parallel exploration of nonhuman ecologies eventually diverges. Where Deleuze dives head-first into a world of matter and molecules, Denis traces a more dynamic trajectory. Through attention to the racial and postcolonial dynamics of the environments she surveys, she inflects Deleuze’s fusional ontology with a more careful thinking of alterity. Antisocial drives, in Denis, are able to be recuperated into a renewed human sociality, one that is traversed and maintained by environmental processes.
Aging Successfully in the Changing Norwegian Welfare State: A Policy Analysis Framed by Critical Gerontology
Authors: Blix Bodil H , Ågotnes Gudmund
Published: December 2022

Background and Objectives

In the 21st century, the future of the Norwegian welfare state is broadly debated. In Norway, as in other countries, concerns regarding the sustainability and affordability of the welfare state in light of the projected population development have been voiced in public and academic discourse, and not least in governmental statements and documents. Because we consider texts, such as government white papers, as both products and producers of discursively based understandings of the social world, a close examination of policy documents can provide insight into the predominant understanding of a distinct phenomenon in a specific society at a particular point in time.

Research Design and Methods

The article is based on a critical discourse analysis of 3 recent Norwegian government policy documents addressing the older adult population.

Results

We demonstrate that prominent ideas from the widely contested successful aging paradigm are embedded and forwarded in current Norwegian policies, where ideas about successful and healthy aging produced and reproduced in the documents frame and shape expectations toward older adults.

Discussion and Implications

We argue that the ideas and ideals of successful aging and neoliberalism in parallel pave the way for changes in the historically generous and comprehensive Norwegian social democratic welfare state. For decision makers, the rhetoric of successful aging that emphasizes activity, productivity, self-reliance, and freedom of choice is undoubtedly more convenient to communicate to the public than explicit arguments for the necessity of downscaling public services.
PARP1 and OGG1 in Medicated Patients With Depression and the Response to ECT
Authors: Ryan Karen M , McLoughlin Declan M
Published: December 2022

Background

Oxidative stress and oxidation-induced DNA damage may contribute to the pathophysiology of depression. Two key mediators of base excision repair (BER) in response to oxidative damage of DNA are OGG1 and PARP1. Few studies have examined changes in OGG1 or PARP1 mRNA in patients with depression or following antidepressant treatment. We examined PARP1 and OGG1 mRNA levels in patients with depression at baseline/pre-electroconvulsive therapy (baseline/pre-ECT) vs in healthy controls and in patients following a course of ECT.

Methods

PARP1 and OGG1 were examined in whole blood samples from medicated patients with depression and controls using quantitative real-time polymerase chain reaction. Exploratory subgroup correlational analyses were performed to determine associations between PARP1 and OGG1 and mood (Hamilton Depression Rating Scale 24-item version) scores as well as with vitamin B3, SIRT1, PGC1α, and tumor necrosis factor alpha levels, as previously reported on in this cohort.

Results

PARP1 levels were reduced in samples from patients with depression vs controls (P = .03), though no difference was noted in OGG1. ECT had no effect on PARP1 or OGG1. Higher baseline PARP1 weakly correlated with greater mood improvement post ECT (P = .008). Moreover, PARP1 positively correlated with SIRT1 at baseline and post ECT, and positive correlations were noted between change in PARP1 and change in OGG1 with change in tumor necrosis factor alpha post ECT.

Conclusions

To our knowledge, this is the first study to examine the effect of ECT on BER enzymes. A better understanding of BER enzymes and DNA repair in depression could unearth new mechanisms relevant to the pathophysiology of this condition and novel antidepressant treatments.
Gamification in pharmacy education: a systematic quantitative literature review
Authors: Hope Denise L , Grant Gary D , Rogers Gary D , King Michelle A
Published: December 2022

Objectives

Gamification involves applying game attributes to non-game contexts and its educational use is increasing. It is essential to review the outcomes and the efficacy of gamification to identify evidence to support its use in pharmacy education.

This article

systematically and quantitatively reviews and evaluates the alignment of learning outcomes and the quality of peer-reviewed literature reporting gamification in pharmacy education.

Key findings

A literature search was undertaken in February 2022 using CINAHL Complete, MEDLINE, Science Direct, Scopus and ERIC databases, via keywords (game* OR gaming OR gamif*) AND pharmac* AND education. Google Scholar was searched using ‘gamification of pharmacy education’ and ‘serious games in pharmacy education’. Data extracted included type of gamified intervention, mode of delivery, game fidelity, intended learning outcomes and outcomes reported. Quality assessments aligned with key aspects of the SQUIRE-EDU Reporting Guidelines. Of 759 abstracts and 95 full-text papers assessed, 66 articles met the inclusion criteria. They described gamification from 12 countries in the education of 8272 pharmacy and health professional students. Gamified interventions ranged from board games to immersive simulations, with escape rooms most frequently reported. Reporting quality was inconsistent, with observed misalignment between intended learning outcomes and outcomes reported, an apparent overreliance on student perceptions as primary data and a lack of reference to reporting guidelines.

Gamification is included in the curricula of many pharmacy degrees, across multiple subject areas. This review identified evidence gaps and reinforces the need for improved quality of gamification research, critical alignment of learning outcomes with evaluation, and use of reporting guidelines.
Realisation of Bending Measured Laminations by Kleinian Surface Groups
Authors: Baba Shinpei , Ohshika Ken’ichi
Published: December 2022

For geometrically finite Kleinian surface groups, Bonahon and Otal proved the existence part, and partly the uniqueness part of the bending lamination conjecture. In this paper, we generalise the existence part to general Kleinian surface groups including geometrically infinite ones. Along the way, we also prove the compactness of the set of Kleinian surface groups realising an arbitrarily fixed data of bending laminations and ending laminations. Our proof is independent of that of Bonahon and Otal.
Combined baseline HBcrAg and end-of-treatment HBsAg predict HBV relapse after entecavir or tenofovir cessation
Authors: Tseng Tzu-Ning , Jeng Wen-Juei , Hu Tsung-Hui , Wang Jing-Houng , Hung Chao-Hung , Lu Sheng-Nan , Chen Chien-Hung
Published: December 2022

Background

For patients with chronic hepatitis B (CHB), the optimal stopping criteria for entecavir or tenofovir disoproxil fumarate treatment remain unclear.

Methods

This study recruited CHB patients with levels of hepatitis B surface antigen (HBsAg) <100 IU/mL at the end of treatment (EOT) from Kaohsiung (n = 190) and Linkou (n = 188) Chang Gung Memorial Hospitals for use as development and validation groups, respectively.

Results

In the development group, 108 patients with HBsAg ≤40 IU/mL were used for analysis of predictors of HBV relapse and HBsAg loss. Multivariate analysis showed that age, nucleos(t)ide analogue (NA)-experienced status, baseline hepatitis B core-related antigen (HBcrAg) and HBsAg at EOT were associated independently with virological and clinical relapse. An HBsAg level of 20 IU/mL at EOT was the best cut-off value for minimizing HBV relapse. Patients with EOT HBsAg ≤20 IU/mL had lower virological and clinical relapse rates and higher HBsAg loss rates than those with EOT HBsAg 21–40 IU/mL and HBsAg 41–100 IU/mL in the development and validation groups. The virological and clinical relapse rates were very low (5-year rates: 6.5% and 0%, respectively) and HBsAg loss rate was very high (5-year rate: 81.7%) in patients with a combination of baseline HBcrAg ≤4 log U/mL and EOT HBsAg ≤20 IU/mL in the development group.

Conclusions

A combination of baseline HBcrAg ≤4 log U/mL and EOT HBsAg level ≤20 IU/mL might reduce the risk of HBV relapse and increase HBsAg loss rate, and might be helpful for off-NA follow-up strategy.
Dam parity affects fetal growth, placental size, and neonatal metabolism in spring-born beef calves
Authors: Duncan Natalie B , Stoecklein Katy S , Foote Andrew P , Meyer Allison M
Published: December 2022

To determine effects of dam parity on perinatal nutrient availability in beef cattle, data and samples were collected from 18 primiparous and 35 multiparous spring-calving Sim-Angus dams and their calves. Time to stand was recorded and neonatal vigor assessed. Jugular blood was collected from a subset of calves at 0 (post-standing and pre-suckling) 6, 12, 24, 48, and 72 h of age, and blood chemistry panels were completed. Expelled placentas were dissected, dried, and weighed. Prepartum maternal circulating glucose, non-esterified fatty acids (NEFA), triglycerides, and urea N were analyzed. All statistical models included the fixed effect of dam parity, and calf sex (when P ≤ 0.25) was included for calf and placental variables. Effects of sampling hour, and parity × hour were included for calf metabolites over time using repeated measures. Multiparous dams had greater body weight prepartum (P < 0.001) but similar (P = 0.25) body condition score. Maternal circulating urea N and triglycerides were greater (P ≤ 0.05) in multiparous dams pre-calving. Calves born to primiparous dams weighed 10% less (P ≤ 0.04) at birth with smaller (P ≤ 0.01) heart and abdominal girths. Cotyledonary, intercotyledonary, and total placental masses were less (P ≤ 0.05) for primiparous dams. Dam parity did not affect (P ≥ 0.58) calf time to stand, vigor score at 10 min, or rectal temperature. Serum glucose was greater (P = 0.03) at 0 h but less (P ≤ 0.04) at all other hours in calves from primiparous dams. Calves from primiparous dams had greater (P ≤ 0.02) serum NEFA at 6, 12, and 24 h although plasma triglycerides were greater (P < 0.001) at 6 h. Calves from primiparous dams had greater (P ≤ 0.04) serum urea N at 12 h and creatinine at 12 and 24 h. Plasma insulin was greater (P ≤ 0.04) in calves from multiparous dams at 12, 48, and 72 h, but parity did not affect (P ≥ 0.18) serum total protein or plasma cortisol. Serum aspartate aminotransferase was greater (P ≤ 0.04) at 6 and 24 h, creatine kinase was greater at 24 h, and gamma-glutamyl transpeptidase was less (P ≤ 0.04) at 6, 12, and 24 h, for calves from primiparous dams. Calves born to primiparous dams had greater (P ≤ 0.02) total bilirubin and direct bilirubin at 12 and 24 h. Data indicate that calves born to first-parity heifers had decreased perinatal nutrient availability, resulting in reduced fetal and placental growth, as well as greater energy reserve mobilization and metabolic indicators of stress as neonates.
Intuitive approach for design of inner structure by mimicking magnetic effect
Authors: Kam Dong Uk , Lee Kunwoo
Published: December 2022

Three-dimensional (3D) printers enable the realization of parts with complex shapes, particularly parts with an internal structure as well as an external shape. They are beginning to be used in real production as well as for prototyping. Because 3D printers allow shapes for parts that could not be imagined when conventional machining processes were the only fabrication methods, designers need to design porous parts with minimum weights that can maintain the required load-bearing capability without concerns about the realization of those parts. However, designers cannot design the internal structure of the parts using the current computer-aided design systems as freely as they can design the external shape. Therefore, in this paper, an intuitive design tool is proposed for users to interactively design an internal structure inside given external shape. To create a porous structure inside given closed volume, we aimed to generate a honeycomb-like structure comprising cells whose size and crowdedness can be intuitively manipulated by a designer. Thus, fine cells exist in certain regions, while coarse cells exist in the remaining regions according to the design. To realize this aim, the phenomenon in which more iron particles are attracted near a magnet and fewer are attracted further away from the magnet is imitated. More and finer honeycomb-like cells are attracted near a magnet located on the external surface of the closed volume. The designer can add magnets and move them on the external surface until the desired internal honeycomb-like structure is obtained.
Accelerated hypofractionated radiotherapy with 3 Gy per fraction for central/ultra-central lung tumors: toxicity to mediastinal organs
Authors: Ito Kei , Minakami Shota , Nakajima Yujiro , Karasawa Katsuyuki
Published: December 2022

Background

Accelerated hypofractionated radiotherapy with 3 Gy per fraction is routinely performed for central lung tumors in Japan. However, the tolerable doses to mediastinal organs at risk during this procedure are unclear. This study aimed to clarify the rate of toxicities and tolerable doses to mediastinal organs.

Methods

Patients treated with accelerated hypofractionated radiotherapy using a total dose of 60–75 Gy, with 3 Gy per fraction, for central lung tumors (July 2009–April 2021) were retrospectively reviewed. We extracted patients who received ≥30 Gy irradiation to each mediastinal organ and analyzed dosimetric factors, including doses to 0.03, 0.5, 1, 4 and 10 mL of each organ, in relation to grade 3–5 toxicities, except for radiation pneumonitis.

Results

In total, 251 organs in 91 (ultra-central, 24) lesions were analyzed, with a median follow-up duration of 26 months (range, 4–94). The prescribed doses were 75/72/69/66/63/60 Gy for 52/14/16/3/2/4 lesions, respectively. Grade 3 bronchopulmonary hemorrhage was confirmed in two (2.2%) patients, whose tumors were located ultra-centrally. The two patients with toxicity received up to 74.5 and 71.6 Gy to the bronchus. Among patients who received 70 Gy or more to the bronchus, the incidence rate was 7% (2/28 patients).

Conclusion

The rate of severe toxicities was low (2.2%). Although we did not identify the dose tolerance of the organs, because of the low incidence rate, we did note that doses of >70 Gy to the bronchus were likely to cause bronchopulmonary hemorrhage.
Ultra-processed food consumption and risk of colorectal cancer precursors: results from 3 prospective cohorts
Authors: Hang Dong , Wang Lu , Fang Zhe , Du Mengxi , Wang Kai , He Xiaosheng , Khandpur Neha , Rossato Sinara L , Wu Kana , Hu Zhibin , Shen Hongbing , Ogino Shuji , Chan Andrew T , Giovannucci Edward L , Zhang Fang Fang , Song Mingyang
Published: December 2022

Background

Growing evidence indicates the adverse effect of ultra-processed food (UPF) consumption. However, it remains unknown whether UPF consumption influences the risk of colorectal cancer (CRC) precursors, namely conventional adenomas and serrated lesions.

Methods

We drew data from the Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-up Study, comprising 142 052 participants who had undergone at least 1 lower gastrointestinal endoscopy during follow-up. To handle multiple records per participants, we used multivariable logistic regression for clustered data to calculate odds ratios (OR) and 95% confidence intervals (CIs) of colorectal polyps in relation to cumulative average consumption of UPFs. All statistical tests were 2-sided.

Results

We documented 11 644 patients with conventional adenomas and 10 478 with serrated lesions during 18-20 years of follow-up. Compared with participants in the lowest quintile of UPF consumption, those in the highest quintile had an increased risk of conventional adenomas (OR = 1.18, 95% CI = 1.11 to 1.26) and serrated lesions (OR = 1.20, 95% CI = 1.13 to 1.28). Similar results were found for high-risk polyps (ie, advanced adenomas and ≥10 mm serrated lesions; OR = 1.17, 95% CI = 1.07 to 1.28). These associations were slightly attenuated but remained statistically significant after further adjusting for body mass index, Western dietary pattern score, or individual dietary factors (fiber, folate, calcium, and vitamin D). The results remained essentially unchanged after excluding processed meat from total UPF intake.

Conclusions

Higher consumption of UPFs is associated with an increased risk of CRC precursors. UPFs might be a modifiable target for early prevention of CRC.