Integration of patient-reported outcome measures with key clinical outcomes after immediate latissimus dorsi breast reconstruction and adjuvant treatment

Background: linical evidence on patient-reported outcome measures (PROMS) in breast reconstruction is lacking. The aim of this study was to evaluate PROMs in implant-assisted latissimus dorsi (LDI) or tissue-only autologous latissimus dorsi (ALD) flap reconstruction in relation to complications and adjuvant treatments.Methods: this was a prospective cohort study involving six UK centres. Eligible patients had primary early-stage breast cancer. The European Organization for Research and Treatment of Cancer quality-of-life questionnaire (QLQ)-C30 and QLQ-BR23, Functional Assessment of Cancer Therapy—Breast Cancer scale (FACT-B), Body Image Scale, and Hospital Anxiety and Depression Scale were completed before operation and at 3, 6 and 12 months after surgery.Results: a total of 182 patients (82 LDI and 100 ALD) were recruited between 2007 and 2010 with symptomatic (59·9 per cent) or screen-detected (39·6 per cent) cancers. Some 64·3 per cent had lymph node-negative disease; 30 per cent of the LDI group had radiotherapy, compared with 53·0 per cent in the ALD group (P = 0·004). Early complications up to 3 months after surgery were reported in 66 and 51·0 per cent of patients in the LDI and ALD groups respectively (P = 0·062) and long-term complications (4–12 months) in 48 and 45·0 per cent (P = 0·845). Role functioning and pain (P = 0·002 for both) were adversely affected in the ALD group compared with results in the LDI group, with no significant effects of radiotherapy on any health-related quality of life (HRQL). Chemotherapy and early complications adversely affected HRQL, which improved between 3 and 12 months after surgery (P < 0·010 for all).Conclusion: there is evidence of similar HRQL between types of latissimus dorsi breast reconstruction for up to a year after surgery. There appear to be no overarching effects for radiotherapy after mastectomy on the specific HRQL domains studied in the short term. The identification of variables that affect HRQL is important, including their integration into the analysis of PROM

Changes in Retinal Structure and Ultrastructure in the Aged Mice Correlate With Differences in the Expression of Selected Retinal miRNAs

Age and gender are two important factors that may influence the function and structure of the retina and its susceptibility to retinal diseases. The aim of this study was to delineate the influence that biological sex and age exert on the retinal structural and ultrastructural changes in mice and to identify the age-related miRNA dysregulation profiles in the retina by gender. Experiments were undertaken on male and female Balb/c aged 24 months (approximately 75–85 years in humans) compared to the control (3 months). The retinas were analyzed by histology, transmission electron microscopy, and age-related miRNA expression profile analysis. Retinas of both sexes showed a steady decline in retinal thickness as follows: photoreceptor (PS) and outer layers (p < 0.01 for the aged male vs. control; p < 0.05 for the aged female vs. control); the inner retinal layers were significantly affected by the aging process in the males (p < 0.01) but not in the aged females. Electron microscopy revealed more abnormalities which involve the retinal pigment epithelium (RPE) and Bruch’s membrane, outer and inner layers, vascular changes, deposits of amorphous materials, and accumulation of lipids or lipofuscins. Age-related miRNAs, miR-27a-3p (p < 0.01), miR-27b-3p (p < 0.05), and miR-20a-5p (p < 0.05) were significantly up-regulated in aged male mice compared to the controls, whereas miR-20b-5p was significantly down-regulated in aged male (p < 0.05) and female mice (p < 0.05) compared to the respective controls. miR-27a-3p (5.00 fold; p < 0.01) and miR-27b (7.58 fold; p < 0.01) were significantly up-regulated in aged male mice vs. aged female mice, whereas miR-20b-5p (−2.10 fold; p < 0.05) was significantly down-regulated in aged male mice vs. aged female mice. Interestingly, miR-27a-3p, miR-27b-3p, miR-20a-5p, and miR-20b-5p expressions significantly correlated with the thickness of the retinal PS layer (p < 0.01), retinal outer layers (p < 0.01), and Bruch’s membrane (p < 0.01). Our results showed that biological sex can influence the structure and function of the retina upon aging, suggesting that this difference may be underlined by the dysregulation of age-related mi-RNAs

Sex and age-related differences in neuroinflammation and apoptosis in balb/c mice retina involve resolvin d1

(1) Background: The pro-resolving lipid mediator Resolvin D1 (RvD1) has already shown protective effects in animal models of diabetic retinopathy. This study aimed to investigate the retinal levels of RvD1 in aged (24 months) and younger (3 months) Balb/c mice, along with the activation of macro-and microglia, apoptosis, and neuroinflammation. (2) Methods: Retinas from male and female mice were used for immunohistochemistry, immunofluorescence, transmission electron microscopy, Western blotting, and enzyme-linked immunosorbent assays. (3) Results: Endogenous retinal levels of RvD1 were reduced in aged mice. While RvD1 levels were similar in younger males and females, they were markedly decreased in aged males but less reduced in aged females. Both aged males and females showed a significant increase in retinal microglia activation compared to younger mice, with a more marked reactivity in aged males than in aged females. The same trend was shown by astrocyte activation, neuroinflammation, apoptosis, and nitrosative stress, in line with the microglia and Müller cell hypertrophy evidenced in aged retinas by electron microscopy. (4) Conclusions: Aged mice had sex-related differences in neuroinflammation and apoptosis and low retinal levels of endogenous RvD1

Индивидуализация лечебной тактики при инфильтративном туберкулезе легких

Surgery is performed for treating the pulmonary tuberculosis only when long-term chemotherapy is ineffective. However this can be reconsidered for some patients with the infiltrative tuberculosis. The decision is grounded by the studied mechanism of the tuberculous inflammation development together with a common origin of a collagen and early pneumosclerosis around the caseous necrotic zones. This causes aggravation of the chemiospecimen penetration into tuberculous foci. At the same time bactericidal activity of alveolar macrophages reduces. Thus the process preserves activity but takes on flabby and torpid course. Its dynamics together with the pneumosclerosis origin are controlled by the examination of the sputum cytogram, the bactericidal activity of 4 alveolar macrophages as well as the contents of the malonic dialdehyde, histamine and serotonin. By the 4th month of the treatment the high values of these indexes on the background of a corresponding X-ray picture can be considered an indication for a minor pneumonectomy. By December 1995 fifteen of the 72 examined patients had been successfully operated. The surgery at an early stage advances a more prompt and effective pulmonary tuberculosis treatment. Surgery can be a cure alternative to a long and continuos chemotherapy.В лечении туберкулеза легких хирургические методы применяются лишь при неэффективности длительной химиотерапии. Однако в отношении ряда больных инфильтративным туберкулезом такое положение может быть пересмотрено. Основанием для этого являются изученные закономерности течения туберкулезного воспаления с нередким образованием коллагена и ранним возникновением фиброза вокруг казеозно-некротических зон. В результате ухудшается проникновение химиопрепаратов в туберкулезные очаги и фокусы. Одновременно снижается бактерицидная активность альвеолярных макрофагов. Процесс сохраняет активность, но приобретает вялое, торпидное течение. Контроль за его динамикой и образованием фиброза осуществляется исследованием цитограммы лаважной жидкости, бактерицидной активности альвеолярных макрофагов, а также малонового диальдегида, гистамина и серотонина крови. Их высокий уровень к 4-му мес лечения на фоне соответствующей рентгенологической картины может рассматриваться как показание к малой резекции легкого. К декабрю 1995 года из 72 обследованных больных успешно оперированы 15 человек. Хирургическое вмешательство на раннем этапе способствует более быстрому и эффективному лечению туберкулеза легких и может быть методом, альтернативным длительной и непрерывной химиотерапии

Expression and function of resolvin RvD1(n-3 DPA) receptors in oral epithelial cells

Chronic inflammatory responses can inflict permanent damage to host tissues. Specialized pro-resolving mediators downregulate inflammation but also can have other functions. The aim of this study was to examine whether oral epithelial cells express the receptors FPR2/ALX and DRV1/GPR32, which bind RvD1(n-3 DPA) , a recently described pro-resolving mediator derived from omega-3 docosapentaenoic acid (DPA), and whether RvD1(n-3 DPA) exposure induced significant responses in these cells. Gingival biopsies were stained using antibodies to FPR2/ALX and DRV1/GPR32. Expression of FPR2/ALX and DRV1/GPR32 was examined in primary oral epithelial cells by qRT-PCR, flow cytometry, and immunofluorescence. The effect of RvD1(n-3 DPA) on intracellular calcium mobilization and transcription of beta-defensins 1 and 2, and cathelicidin was evaluated by qRT-PCR. FPR2/ALX and DRV1/GPR32 were expressed by gingival keratinocytes in situ. In cultured oral epithelial cells, FPR2/ALX was detected on the cell surface, whereas FPR2/ALX and DRV1/GPR32 were detected intracellularly. Exposure to RvD1(n-3 DPA) induced intracellular calcium mobilization, FPR2/ALX internalization, DRV1/GPR32 translocation to the nucleus, and significantly increased expression of genes coding for beta-defensin 1, beta-defensin 2, and cathelicidin. This shows that the signal constituted by RvD1(n-3 DPA) is recognized by oral keratinocytes and that this can strengthen the antimicrobial and regulatory potential of the oral epithelium

Animal models for COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the aetiological agent of coronavirus disease 2019 (COVID-19), an emerging respiratory infection caused by the introduction of a novel coronavirus into humans late in 2019 (first detected in Hubei province, China). As of 18 September 2020, SARS-CoV-2 has spread to 215 countries, has infected more than 30 million people and has caused more than 950,000 deaths. As humans do not have pre-existing immunity to SARS-CoV-2, there is an urgent need to develop therapeutic agents and vaccines to mitigate the current pandemic and to prevent the re-emergence of COVID-19. In February 2020, the World Health Organization (WHO) assembled an international panel to develop animal models for COVID-19 to accelerate the testing of vaccines and therapeutic agents. Here we summarize the findings to date and provides relevant information for preclinical testing of vaccine candidates and therapeutic agents for COVID-19

30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data

Background: There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. Materials and methods: This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien–Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. Results: In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). Conclusions: This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts

Factors influencing user acceptance of public sector big open data

In recent years Government departments and public/private organizations are becoming increasingly transparent with their data to establish the whole new paradigm of big open data. Increasing research interest arises from the claimed usability of big open data in improving public sector reforms, facilitating innovation, improving supplier and distribution networks and creating resilient supply chains that help improve the efficiency of public services. Despite the advantages of big open data for supply chain and operations management, there is severe shortage of empirical analyses in this field, especially with regards to its acceptance. To address this gap, in this paper we use an extended Technology Acceptance Model (TAM) to empirically examine the factors affecting users’ behavioural intentions towards public sector big open data. We outline the importance of our model for operations and supply chain managers, the limitations of the study, and future research directions

Post-harvest management and associated food losses and by-products of cassava in southern Ethiopia

Improved (high yield and disease resistant) cassava varieties were introduced into Ethiopia around the onset of the twenty-first century, as a potential food security crop. At present, limited information is available from the country on post-production aspects of the value chain (VC) and related food losses. The lack of such data prevents policymakers and VC actors from taking steps towards improving VC efficiencies, which can have a significant impact on livelihoods and food security. The focus of this study was to examine the prevailing post-harvest practices in the cassava VC in southern Ethiopia and quantify the extent of food losses and associated by-products in the framework of the recently developed ‘food loss and waste protocol’. The majority of the cassava in the study area was processed into dry chips and milled into a composite flour with teff and maize to prepare the staple bread (injera). ‘Critical loss points’ were during sun-drying (4%) and stockpiling at farm and marketplace (30–50%). Insect pest damage was primarily responsible for food losses at farm and market level. The most important insect species infesting dry cassava were identified during the survey. As far as the by-products were concerned, the ratio of leaf:wood (stem and stump):starchy root on a dry matter basis at harvest was 1:6:10. Further emphasis should be on improving processing and storage technologies to reduce food losses and the better recovery and utilisation of by-products, especially the leaves of cassava, which could be a potential source of protein in human diets