The effect of sarcopenia on postoperative outcomes following emergency laparotomy: a systematic review and meta-analysis

Emergency laparotomy procedures have high rates of postoperative mortality and morbidity in older patient. Sarcopenia is associated with poor postoperative outcomes in elective surgeries and there is growing evidence for its use as a risk predictor in the emergency setting. The study aimed to evaluate the effect of sarcopenia on postoperative mortality and morbidity following emergency laparotomy. Five electronic databases were systematically searched (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and Web of Science) from conception until the 14th February 2022. All prospective cohort studies were included. Risk of bias was assessed with the Newcastle-Ottawa score. Pooled meta-analyses were estimated using the Mantel-Haenszel and inverse-generic variance method for mortality and morbidity outcomes. Eleven retrospective cohort studies were included, of which ten were included in the meta-analysis comprising of 3492 patients (1027 sarcopenic, 2465 non-sarcopenic). The study level incidence of sarcopenia ranged from 24.6 to 50.3% with a median rate of 25.1%. Sarcopenia was associated with increased 30-day mortality (OR 2.36, 95% CI, 1.66, 3.37, I2 = 43%), 90-day mortality (OR 2.51, 95% CI, 1.79, 3.52, I2 = 0%), and length of hospital stay (in days) (MD 1.18, 95% CI, 0.42, 1.94, I2 = 0%, P=0.002), but not incidence of postoperative major complications (OR 1.49, 95% CI, 0.86, 2.56, I2 = 70%, P = 0.15). Sarcopenia predicts poor outcomes following emergency laparotomy. We suggest assessment of sarcopenia should be incorporated into acute surgical assessment to identify high risk patients and inform clinical decision-making prior to an emergency laparotomy

Prognostic value of estimated glomerular filtration rate in hospitalised older patients (over 65) with COVID-19 : a multicentre, European, observational cohort study

Acknowledgements: COPE Team Members (collaborators). Funding: No funding declared for this study. The Study was sponsored by Cardiff University who had no role on the study design, analysis or interpretation of the findings. BC is partially supported by the NIHR Maudsley Biomedical Research Centre at South London Maudsley NHS Foundation Trust, and King's College London. EAR received the Gwyn Seymour Scholarship from the Department of Medicine for the Elderly, NHS Grampian, as part of the Aberdeen Summer Research Scholarship Scheme, Aberdeen Clinical Academic Training Programme, University of Aberdeen.Peer reviewedPublisher PD

Towards a global land surface climate fiducial reference measurements network

There is overwhelming evidence that the climate system has warmed since the instigation of instrumental meteorological observations. The Fifth Assessment Report of the Intergovernmental Panel on Climate Change concluded that the evidence for warming was unequivocal. However, owing to imperfect measurements and ubiquitous changes in measurement networks and techniques, there remain uncertainties in many of the details of these historical changes. These uncertainties do not call into question the trend or overall magnitude of the changes in the global climate system. Rather, they act to make the picture less clear than it could be, particularly at the local scale where many decisions regarding adaptation choices will be required, both now and in the future. A set of high-quality long-term fiducial reference measurements of essential climate variables will enable future generations to make rigorous assessments of future climate change and variability, providing society with the best possible information to support future decisions. Here we propose that by implementing and maintaining a suitably stable and metrologically well-characterized global land surface climate fiducial reference measurements network, the present-day scientific community can bequeath to future generations a better set of observations. This will aid future adaptation decisions and help us to monitor and quantify the effectiveness of internationally agreed mitigation steps. This article provides the background, rationale, metrological principles, and practical considerations regarding what would be involved in such a network, and outlines the benefits which may accrue. The challenge, of course, is how to convert such a vision to a long-term sustainable capability providing the necessary well-characterized measurement series to the benefit of global science and future generations

An empirical investigation of dance addiction

Although recreational dancing is associated with increased physical and psychological well-being, little is known about the harmful effects of excessive dancing. The aim of the present study was to explore the psychopathological factors associated with dance addiction. The sample comprised 447 salsa and ballroom dancers (68% female, mean age: 32.8 years) who danced recreationally at least once a week. The Exercise Addiction Inventory (Terry, Szabo, & Griffiths, 2004) was adapted for dance (Dance Addiction Inventory, DAI). Motivation, general mental health (BSI-GSI, and Mental Health Continuum), borderline personality disorder, eating disorder symptoms, and dance motives were also assessed. Five latent classes were explored based on addiction symptoms with 11% of participants belonging to the most problematic class. DAI was positively associated with psychiatric distress, borderline personality and eating disorder symptoms. Hierarchical linear regression model indicated that Intensity (ß=0.22), borderline (ß=0.08), eating disorder (ß=0.11) symptoms, as well as Escapism (ß=0.47) and Mood Enhancement (ß=0.15) (as motivational factors) together explained 42% of DAI scores. Dance addiction as assessed with the Dance Addiction Inventory is associated with indicators of mild psychopathology and therefore warrants further research

Generalized Fock Spaces, New Forms of Quantum Statistics and their Algebras

We formulate a theory of generalized Fock spaces which underlies the different forms of quantum statistics such as ``infinite'', Bose-Einstein and Fermi-Dirac statistics. Single-indexed systems as well as multi-indexed systems that cannot be mapped into single-indexed systems are studied. Our theory is based on a three-tiered structure consisting of Fock space, statistics and algebra. This general formalism not only unifies the various forms of statistics and algebras, but also allows us to construct many new forms of quantum statistics as well as many algebras of creation and destruction operators. Some of these are : new algebras for infinite statistics, q-statistics and its many avatars, a consistent algebra for fractional statistics, null statistics or statistics of frozen order, ``doubly-infinite'' statistics, many representations of orthostatistics, Hubbard statistics and its variations.Comment: This is a revised version of the earlier preprint: mp_arc 94-43. Published versio

Detection of antibodies directed at M. hyorhinis p37 in the serum of men with newly diagnosed prostate cancer

<p>Abstract</p> <p>Background</p> <p>Recent epidemiologic, genetic, and molecular studies suggest infection and inflammation initiate certain cancers, including cancers of the prostate. Over the past several years, our group has been studying how mycoplasmas could possibly initiate and propagate cancers of the prostate. Specifically, <it>Mycoplasma hyorhinis </it>encoded protein p37 was found to promote invasion of prostate cancer cells and cause changes in growth, morphology and gene expression of these cells to a more aggressive phenotype. Moreover, we found that chronic exposure of benign human prostate cells to <it>M. hyorhinis </it>resulted in significant phenotypic and karyotypic changes that ultimately resulted in the malignant transformation of the benign cells. In this study, we set out to investigate another potential link between mycoplasma and human prostate cancer.</p> <p>Methods</p> <p>We report the incidence of men with prostate cancer and benign prostatic hyperplasia (BPH) being seropositive for <it>M. hyorhinis</it>. Antibodies to <it>M. hyorhinis </it>were surveyed by a novel indirect enzyme-linked immunosorbent assay (ELISA) in serum samples collected from men presenting to an outpatient Urology clinic for BPH (N = 105) or prostate cancer (N = 114) from 2006-2009.</p> <p>Results</p> <p>A seropositive rate of 36% in men with BPH and 52% in men with prostate cancer was reported, thus leading us to speculate a possible connection between <it>M. hyorhinis </it>exposure with prostate cancer.</p> <p>Conclusions</p> <p>These results further support a potential exacerbating role for mycoplasma in the development of prostate cancer.</p

Type I interferon/IRF7 axis instigates chemotherapy-induced immunological dormancy in breast cancer

Neoadjuvant and adjuvant chemotherapies provide survival benefits to breast cancer patients, in particular in estrogen receptor negative (ER-) cancers, by reducing rates of recurrences. It is assumed that the benefits of (neo)adjuvant chemotherapy are due to the killing of disseminated, residual cancer cells, however, there is no formal evidence for it. Here, we provide experimental evidence that ER- breast cancer cells that survived high-dose Doxorubicin and Methotrexate based chemotherapies elicit a state of immunological dormancy. Hallmark of this dormant phenotype is the sustained activation of the IRF7/IFN-beta/IFNAR axis subsisting beyond chemotherapy treatment. Upregulation of IRF7 in treated cancer cells promoted resistance to chemotherapy, reduced cell growth and induced switching of the response from a myeloid derived suppressor cell-dominated immune response to a CD4(+)/CD8(+) T cell-dependent anti-tumor response. IRF7 silencing in tumor cells or systemic blocking of IFNAR reversed the state of dormancy, while spontaneous escape from dormancy was associated with loss of IFN-beta production. Presence of IFN-beta in the circulation of ER- breast cancer patients treated with neoadjuvant Epirubicin chemotherapy correlated with a significantly longer distant metastasis-free survival. These findings establish chemotherapy-induced immunological dormancy in ER- breast cancer as a novel concept for (neo)adjuvant chemotherapy activity, and implicate sustained activation of the IRF7/IFN-beta/IFNAR pathway in this effect. Further, IFN-beta emerges as a potential predictive biomarker and therapeutic molecule to improve outcome of ER- breast cancer patients treated with (neo)adjuvant chemotherapy.Peer reviewe