Overlapping Agencies: The Collision of Cancer, Consumers, and Corporations in Richard Powers’s Gain

Richard Powers\u27s 1998 novel Gain establishes a complicated relationship between its two main characters, a corporation called Clare International and suburban mom named Laura Bodey. Readers, assuming the malignity of such corporations, mistake the hints Laura encounters that Clare is responsible for her ovarian cancer for facts. Such readings overlook the science of ovarian cancer as well as how Powers depicts Laura\u27s relation to her disease. I analyze Laura\u27s understudied half of the novel, framing it as a cancer narrative that reworks conventions of that genre. In placing her cancer in broad social and environmental contexts, Powers eschews the individualist strain that characterizes many illness narratives. In so doing, the novel demands engagement with consumer agency and bodily frailty in the face of corporate dominance

Zfp488 promotes oligodendrocyte differentiation of neural progenitor cells in adult mice after demyelination

Basic helix-loop-helix transcription factors Olig1 and Olig2 critically regulate oligodendrocyte development. Initially identified as a downstream effector of Olig1, an oligodendrocyte-specific zinc finger transcription repressor, Zfp488, cooperates with Olig2 function. Although Zfp488 is required for oligodendrocyte precursor formation and differentiation during embryonic development, its role in oligodendrogenesis of adult neural progenitor cells is not known. In this study, we tested whether Zfp488 could promote an oligodendrogenic fate in adult subventricular zone (SVZ) neural stem/progenitor cells (NSPCs). Using a cuprizone-induced demyelination model in mice, we examined the effect of retrovirus-mediated Zfp488 overexpression in SVZ NSPCs. Our results showed that Zfp488 efficiently promoted the differentiation of the SVZ NSPCs into mature oligodendrocytes in vivo. After cuprizone-induced demyelination injury, Zfp488-transduced mice also showed significant restoration of motor function to levels comparable to control mice. Together, these findings identify a previously unreported role for Zfp488 in adult oligodendrogenesis and functional remyelination after injury

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

The performance of affordable and stable cellulose-based poly-ionic membranes in CO2/N-2 and CO2/CH4 gas separation

© 2018 Elsevier B.V. The majority of commercial membrane units for large-scale natural gas sweetening are based on cellulose acetate (CA). However, the low selectivity and risk for and plasticisation affect adversely the performance of CA-based systems. Herein, we present a new class of CA-derived poly(ionic liquid) (PIL) as a thin film composite (TFC) membrane for CO2 separations. CA is modified with pyrrolidinium cations through alkylation of butyl chloride, substituting the hydroxyl group in the polymer backbone, and further anion exchange to bis(trifluoromethylsulfonyl)imide, P[CA][Tf2N]. The synthesised PIL material properties are extensively studied. The CO2 separation performance of the newly synthesised materials is evaluated by gravimetric gas sorption experiments, single gas time-lag experiments on thick membranes, and mixed-gas separation experiments on TFC membranes. The results are compared to the parent material (CA) as well as a reference PIL (poly(diallyldimethyl ammonium) bis(trifluoromethylsulfonyl)imide (P[DADMA][Tf2N])). The ideal CO2/N2 sorption selectivity of P[CA][Tf2N] is constant up to 10 bar. The single gas transport measurements in P[CA][Tf2N] reveal improved ideal CO2 selectivity for the CO2/N2 gas pair and increased CO2 permeability for the CO2/CH4 gas pair compared to the reference PIL. Mixed-gas permeation tests demonstrated that P[CA][Tf2N]-based membranes with a 5 µm thick selective layer has a two-fold higher CO2 flux compared to conventional CA. These results present CA modification into PILs as a successful approach promoting the higher permeate flows and improved process stability in a wide range of concentrations and pressures of CO2/N2 and CO2/CH4 gas mixtures.status: publishe

Expert Multinational Consensus Statement for Total Intravenous Anaesthesia (TIVA) Using the Delphi Method

Introduction: The use of total intravenous anaesthesia (TIVA) has been well established as an anaesthetic technique over the last few decades. Significant variation in practice exists however, and volatile agents are still commonly used. This study aims to determine the motivations and barriers for using TIVA over the use of volatile agents by analysing the opinion of several international anaesthetists with specific expertise or interests. Methods and participants: The Delphi method was used to gain the opinions of expert panellists with a range of anaesthetic subspecialty expertise. Twenty-nine panellists were invited to complete three survey rounds containing statements regarding the use of TIVA. Anonymised data were captured through the software REDCap and analysed for consensus and prioritisation across statements. Starting with 12 statements, strong consensus was defined as ≥75% agreement. Stability was assessed between rounds. Results: Strong consensus was achieved for four statements regarding considerations for the use of TIVA. These statements addressed whether TIVA is useful in paediatric anaesthesia, the importance of TIVA in reducing the incidence of postoperative nausea and vomiting, its positive impact on the environment and effect on patient physiology, such as airway and haemodynamic control. Conclusions: Using the Delphi method, this international consensus showed that cost, lack of familiarity or training and the risk of delayed emergence are not considered obstacles to TIVA use. It appears, instead, that the primary motivations for its adoption are the impact of TIVA on patient experience, especially in paediatrics, and the benefit to the overall procedure outcome. The effect of TIVA on postoperative nausea and vomiting and patient physiology, as well as improving its availability in paediatrics were considered as priorities. We also identified areas where the debate remains open, generating new research questions on geographical variation and the potential impact of local availability of monitoring equipment