The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Sustainability centres and fit: how centres work to integrate sustainability within business schools

For nearly as long as the topic of sustainable business has been taught and researched in business schools, proponents have warned about barriers to genuine integration in business school practices. This article examines how academic sustainability centres try to overcome barriers to integration by achieving technical, cultural and political fit with their environment (Ansari, Fiss, & Zajac, 2010). Based on survey and interview data, we theorise that technical, cultural and political fit are intricately related, and that these interrelations involve legitimacy, resources and collaboration effects. Our findings about sustainability centres offer novel insights on integrating sustainable business education given the interrelated nature of different types of fit and misfit. We further contribute to the literature on fit by highlighting that incompatibility between strategies to achieve different types of fit may act as a source of dynamism

Isolation in Globalizing Academic Fields: A Collaborative Autoethnography of Early Career Researchers

This study examines academic isolation – an involuntary perceived separation from the academic field to which one aspires to belong, associated with a perceived lack of agency in terms of one’s engagement with the field – as a key challenge for researchers in increasingly globalized academic careers. While prior research describes early career researchers’ isolation in their institutions, we theorize early career researchers’ isolation in their academic fields and reveal how they attempt to mitigate isolation to improve their career prospects. Using a collaborative autoethnographic approach, we generate and analyze a dataset focused on the experiences of ten early career researchers in a globalizing business academic field known as Consumer Culture Theory. We identify bricolage practices, polycentric governance practices, and integration mechanisms that work to enhance early career researchers’ perceptions of agency and consequently mitigate their academic isolation. Our findings extend discussions on isolation and its role in new academic careers. Early career researchers, in particular, can benefit from a deeper understanding of practices that can enable them to mitigate isolation and reclaim agency as they engage with global academic fields

Pathophysiological Aspects of Aging in Venous Thromboembolism: An Update

The aim of this review is to highlight all the factors that associate venous thromboembolism (VTE) with aging. Elderly people are characterized by a higher incidence of thrombosis taking into account the co-existing comorbidities, complications and fatality that arise. Based on the Virchow triad, pathophysiological aspects of venous stasis, endothelium injury and hypercoagulability in elderly people (≥65 years) are described in detail. More precisely, venous wall structure, nitric oxide (NO) and endothelin-1 expression are impaired in this age group. Furthermore, an increase in high-molecular-weight kininogen (HMWK), prekallikrein, factors V, VII, VIII, IX and XI, clot lysis time (CLT) and von Willebrand factor (vWF) is observed. Age-dependent platelet dysfunction and changes in anticoagulant factors are also illustrated. A “low-grade inflammation stage” is delineated as a possible risk factor for thrombosis in the elderly. Consequently, clinical implications for frail elderly people related to diagnosis, treatment, bleeding danger and VTE recurrence emerge. We conclude that aging is an acquired thrombotic factor closely related to pathophysiological changes. © 2022 by the authors

Antibacterial activity of griseofulvin analogues as an example of drug repurposing

Griseofulvin is a well-known antifungal drug that was launched in 1962 by Merck & Co. for the treatment of dermatophyte infections. However, according to predictions using the Way2Drug computational drug repurposing platform, it may also have antibacterial activity. As no confirmation of this prediction was found in the published literature, this study estimated in-silico antibacterial activity for 42 griseofulvin derivatives. Antibacterial activity was predicted for 33 of the 42 compounds, which led to the conclusion that this activity might be considered as typical for this chemical series. Therefore, experimental testing of antibacterial activity was performed on a panel of Gram-positive and Gram-negative micro-organisms. Antibacterial activity was evaluated using the microdilution method detecting the minimal inhibitory concentration (MIC) and the minimal bactericidal concentration (MBC). The tested compounds exhibited potent antibacterial activity against all the studied bacteria, with MIC and MBC values ranging from 0.0037 to 0.04 mg/mL and from 0.01 to 0.16 mg/mL, respectively. Activity was 2.5–12 times greater than that of ampicillin and 2–8 times greater than that of streptomycin, which were used as the reference drugs. Similarity analysis for all 42 compounds with the (approximately) 470,000 drug-like compounds indexed in the Clarivate Analytics Integrity database confirmed the significant novelty of the antibacterial activity for the compounds from this chemical class. Therefore, this study demonstrated that by using computer-aided prediction of biological activity spectra for a particular chemical series, it is possible to identify typical biological activities which may be used for discovery of new applications (e.g. drug repurposing)

Postherpes simplex encephalitis: a case series of viral-triggered autoimmunity, synaptic autoantibodies and response to therapy

Background: Recent evidence suggests that patients with herpes simplex virus (HSV) encephalitis may relapse because of autoimmunity against the N-methyl-D-aspartate receptor (NMDAR). We present a case series of post-HSV relapsing encephalopathy associated with antibodies to central nervous system (CNS) synaptic antigens. Patient/Methods: Sera and cerebrospinal fluid (CSF) from five patients with HSV encephalitis who relapsed after antiviral therapy were tested for anti-NMDAR, gamma-aminobutyric acid b receptor (GABAbR), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), Leucine-rich, glioma inactivated 1 (LGI1), anti -contactin-associated protein-like 2 (CASPR2) and dipeptidyl-peptidase-like protein-6 (DDPX) antibodies using cell-based assays. Results: Five patients (two infants, one child and two adults) developed post-HSV autoimmune encephalitis. The infants, aged 9 months and 10 months, after prompt and seemingly successful anti-HSV therapy, were readmitted with typical signs of NMDAR-encephalitis evolving within days, with NMDAR antibodies detected in both serum and CSF. Although they were promptly treated with intravenous immunoglobulin (IVIg) and with IVIg followed by rituximab, respectively, they were both left with psychomotor deficits. A 14-year-old girl with seizures due to HSV encephalitis improved with anti-HSV therapy. Later, she manifested intractable seizures and she was found positive for anti-NMDAR antibodies which persist. The two adults were women, aged 58 and 33 years. The first recovered after anti-HSV therapy and remained asymptomatic for 6 months, until she developed generalized seizures with persisting CSF anti-NMDAR antibodies; the second, who continued to be encephalopathic after 2 weeks of anti-HSV therapy, tested positive for anti-NMDAR antibodies in the serum and anti-GABAbR antibodies in the serum and CSF. She recovered fully following IVIg therapy but her serum anti-GABAbR antibodies persist 34 months later. Discussion: Infection of the CNS with HSV can trigger CNS autoimmunity associated not only with anti-NMDAR but also with anti-GABAbR antibodies. These antibodies can persist in the serum, even without associated symptoms, but their presence in the CSF is firmly associated with disease development. In contrast to children and adults who responded well to therapies, the infants had an incomplete recovery with severe psychomotor deficits probably due to the interference of anti-NMDAR antibodies with neuro-developmental processes. © The Author(s), 2018

Educating integrated catalysts: transforming business schools toward ethics and sustainability

Joining the sharpening critique of conventional University-based business school education, we argue that educating integrated catalysts is necessary to meet current sustainability challenges. The key feature of moving toward the integration required at the individual level is focusing on developing students' capacity for moral and cognitive maturity. Practically, this makes the practice of genuine dialogue focal as core interpersonal method for educating management students. In supporting such education, business schools must however first transform themselves. Acting as transformative social enterprises, they can demonstrate being a part in critically questioning and improving the impact and relevance of management on the flourishing of wider society and the practice of an ethically oriented economy. We offer practical suggestions and implications for future business education reform

Conjuring A ‘Spirit’ for Sustainability: a review of the socio-materialist effects of provocative pedagogies

Evidence suggests that wider sociological structures, which embody particular values and ways of relating, can make sustainable living and working problematic. This paper introduces ideology critique, an innovative methodological perspective crossing the fields of theology, cultural studies and politics, to examine and disturb the subtle and hidden ‘spirit’ which is evoked when we engage with everyday objects and interactions. Such a ‘spirit’, or ideology, embodies particular models of how humans relate to other humans, animals, and the planet more broadly. This paper aims, firstly, to document and demonstrate the subtleties of how the hidden ‘spirit’ can render attempts at sustainable working futile in the context of education, and then, second, to demonstrate how it can be used to intentionally evoke alternative ‘spirits’ which afford new relationality amongst humans, animals and the planet. In a broader sense, therefore, this paper explores how concepts and political commitments from the humanities, such as ideology critique and ‘spirit’, can help (1) analyse how wider social structures shape our values and beliefs in relation to sustainable learning, living and working, (2) explain how these behaviours are held in place over time, and (3) provoke insight into how we might seek to disrupt and change such persistent social structures

Commodity risk assessment of Berberis thunbergii potted plants from Turkey

The European Commission requested the EFSA Panel&nbsp;on Plant Health to prepare and deliver risk assessments for commodities listed in the Commission Implementing Regulation (EU) 2018/2019 as 'High-risk plants, plant products and other objects'. This Scientific Opinion covers plant health risks posed by potted plants (2-3 years old) of Berberis thunbergii produced in nurseries and imported into the EU from Turkey, taking into account the available scientific information, including the technical information provided by the NPPO of Turkey. The relevance of any pest for this Opinion was based on evidence following defined criteria. Two species, the EU-quarantine pest Bemisia tabaci and the non-regulated pest Malacosoma parallela, fulfilled the relevant criteria and were selected for further evaluation. For these pests, the risk mitigation measures proposed in the technical dossier from Turkey were evaluated taking into account the possible limiting factors. For these pests, an expert judgement is given on the likelihood of pest freedom taking into consideration the risk mitigation measures acting on the pest, including uncertainties associated with the assessment. The estimated degree of pest freedom varies among the pests evaluated, with B. tabaci being the pest most frequently expected on the imported plants. The Expert Knowledge Elicitation indicated, with 95% certainty, that between 9,928 and 10,000 plants per 10,000 would be free of B. tabaci. The role of Berberis thunbergii as possible host of Puccinia spp. is discussed in the body of the opinion