Arterial Occlusion and Acute Deep Vein Thrombosis-Induced Acute Limb Ischemia in a COVID-19 Patient

Coronavirus disease 2019 (COVID-19) is a viral illness known to elicit a hypercoagulable state leading to a myriad of vascular pathologies. Over the course of the COVID-19 pandemic, widespread insults to the venous system have been well documented, with an increasing number of arterial events being reported. Despite the rising incidence of both pathological manifestations, these events are rare, but when present, serve as significant life threats to the patient in question. We report and discuss a case of a 69-year-old female with no thromboembolic risk factors or systemic signs of illness who presented with signs and symptoms consistent with acute limb ischemia (ALI). The patient was ultimately found to have occlusion of multiple arterial and venous vessels. She tested positive for COVID-19 despite being otherwise asymptomatic from a viral syndrome standpoint. To our knowledge, there are no reports in the medical literature of ALI - in the setting of arterial occlusion and concomitant deep vein thrombosis (DVT) - as the sole clinical manifestation in an asymptomatic patient without thrombotic risk factors who was only incidentally found to be COVID-19-positive. This case underscores the atypical manifestations and deleterious effects associated with COVID-19 and the need to have a high index of suspicion for a multitude of pathologies when facing this viral illness

Techniques employed to create event prestige value for corporate VIPs: the V.I.P. Framework.

This research explored the techniques employed by event managers to create event prestige value for VIPs in a corporate events context. Research on prestige has mainly focused on the attributes that deliver prestige value (the prestige values). However, by focusing on those delivering prestige (as opposed to the recipients of prestige), this research identified two deeper, less explicit mechanisms required to deliver prestigious experiences, labelled Interaction and Principles. By identifying a more comprehensive set of techniques, those designing VIP experiences will be better equipped to satisfy the prestige needs of VIPs

Screening natural libraries of human milk oligosaccharides against lectins using CaR-ESI-MS

Human milk oligosaccharides (HMOs) afford many health benefits to breast-fed infants, such as protection against infection and regulation of the immune system, through the formation of noncovalent interactions with protein receptors. However, the molecular details of these interactions are poorly understood. Here, we describe the application of catch-and-release electrospray ionization mass spectrometry (CaR-ESI-MS) for screening natural libraries of HMOs against lectins. The HMOs in the libraries were first identified based on molecular weights (MWs), ion mobility separation arrival times (IMS-ATs) and collision-induced dissociation (CID) fingerprints of their deprotonated anions. The libraries were then screened against lectins and the ligands identified from the MWs, IMS-ATs and CID fingerprints of HMOs released from the lectin in the gas phase. To demonstrate the assay, four fractions, extracted from pooled human milk and containing ≥35 different HMOs, were screened against a C-terminal fragment of human galectin-3 (hGal-3C), for which the HMOs specificities have been previously investigated, and a fragment of the blood group antigen-binding adhesin (BabA) from Helicobacter pylori, for which the HMO specificities have not been previously established. The structures of twenty-one ligands, corresponding to both neutral and acidic HMOs, of hGal-3C were identified; all twenty one were previously shown to be ligands for this lectin. The presence of HMO ligands at six other MWs was also ascertained. Application of the assay to BabA revealed nineteen specific HMO structures that are recognized by the protein and HMO ligands at two other MWs. Notably, it was found that BabA exhibits broad specificity for HMOs, and recognizes both neutral HMOs, including non-fucosylated ones, and acidic HMOs. The results of competitive binding experiments indicate that HMOs can interact with BabA at previously unknown binding sites. The affinities of eight purified HMOs for BabA were measured by ESI-MS and found to be in the 103 M-1 to 104 M-1 range

Comparison of Doxorubicin Plus Docetaxel Neoadjuvant Chemotherapy with Doxorubicin Plus Vinorelbine in Primary Breast Cancer

Purpose: This study was performed to compare the therapeutic efficacy and toxicity of doxorubicin plus docetaxel neoadjuvant chemotherapy (NC) with doxorubicin plus vinorelbine NC. Methods: Fifty-three patients underwent 4 cycles of NC consisted of intravenous injection of doxorubicin (50 mg/m 2) plus docetaxel (75 mg/m 2) administered every 3 weeks (AD), while 49 patients underwent 4 cycles of NC consisted of intravenous injection of doxorubicin (50 mg/m 2) and vinorelbine (25 mg/m 2) administered every 3 weeks (AN). Response rate and treatment-related toxicities were analyzed by administered chemotherapeutics. Response to NC was also analyzed according to clinicobiological characteristics of the primary tumors. Results: Clinical response was observed in 66 % with AN and 81.6 % with AD chemotherapy. A complete pathologic response (pCR) was confirmed in 6 patients (11.3%) with AN and in 7 patients (14.3%) with AD afte

Lasting impressions: ethnic food tour guides, body work, race and gender in southwestern Sydney, Australia

In this paper we examine the racialized and gendered body work required of guides leading ethnic food tours in southwestern Sydney, Australia. We draw on theorists who examine the materialization of race and bodies to extend concepts of intimacy, vulnerability and proximity: dominant themes in studies of occupations involving ‘body work’. To date, very few studies of tour guides have examined the embodied interactions required by the work of guides. Using Ahmed's concepts of inter–embodiment and impressions, we stress that racialized bodies need to be understood as materializing in body work. In particular, we show how body work on the tours includes smiling, vocalization and shepherding and can be understood as contact with the Other. Our paper contributes to the literature on bodily interactions at work in three core ways: first, adding original empirical work on ethnic tour guiding, second, by showing how ‘body work’ is racialized and gendered, and finally, by exploring the relations between food and multicultural intimacies and the vulnerabilities of racialized bodies

Search for Doubly-Charged Higgs Bosons at LEP

Doubly-charged Higgs bosons are searched for in e^+e^- collision data collected with the L3 detector at LEP at centre-of-mass energies up to 209 GeV. Final states with four leptons are analysed to tag the pair-production of doubly charged Higgs bosons. No significant excess is found and lower limits at 95% confidence level on the doubly-charged Higgs boson mass are derived. They vary from 95.5 GeV to 100.2 GeV, depending on the decay mode. Doubly-charged Higgs bosons which couple to electrons would modify the cross section and forward-backward asymmetry of the e^+e^- -> e^+e^- process. The measurements of these quantities do not deviate from the Standard Model expectations and doubly-charged Higgs bosons with masses up to the order of a TeV are excluded

Ki-67 can be used for further classification of triple negative breast cancer into two subtypes with different response and prognosis

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Introduction: Triple negative breast cancer (TNBC) has a poorer survival, despite a higher response rate to neoadjuvant chemotherapy. The purpose of this study was to identify the predictive or prognostic value of Ki-67 among patients with TNBC treated with neoadjuvant chemotherapy, and the role of Ki-67 in further classification of TNBC. Methods: A total of 105 TNBC patients who received neoadjuvant docetaxel/doxorubicin chemotherapy were included in the present study. Pathologic complete response (pCR) rate, relapse-free survival (RFS), and overall survival (OS) were compared according to the level of Ki-67. Results: pCR was observed in 13.3% of patients. TNBC with high Ki-67 expression (>= 10%) showed a higher pCR rate to neoadjuvant chemotherapy than TNBC with low Ki-67 expression. None of the low Ki-67 group achieved pCR (18.2% in the high Ki-67 group vs. 0.0% in the low Ki-67 group, P = 0.019). However, a high Ki-67 expression was significantly associated with poor RFS and OS in TNBC, despite a higher pCR rate (P = 0.005, P = 0.019, respectively). In multivariate analysis, high Ki-67 was an independent prognostic factor for RFS in TNBC (hazard ratio = 7.82, P = 0.002). The high Ki-67 group showed a similar pattern of recurrence with overall TNBC, whereas the low Ki-67 group demonstrated a relatively constant hazard rate for relapse. Conclusions: TNBC with high Ki-67 was associated with a more aggressive clinical feature despite a higher pCR rate. High proliferation index Ki-67 can be used for further classification of TNBC into two subtypes with different responses and prognosis.

External validation and adaptation of a dynamic prediction model for patients with high‐grade extremity soft tissue sarcoma

Background and Objectives: A dynamic prediction model for patients with soft tissue sarcoma of the extremities was previously developed to predict updated overall survival probabilities throughout patient follow‐up. This study updates and externally validates the dynamic model. Methods: Data from 3826 patients with high‐grade extremity soft tissue sarcoma, treated surgically with curative intent were used to update the dynamic PERsonalised SARcoma Care (PERSARC) model. Patients were added to the model development cohort and grade was included in the model. External validation was performed with data from 1111 patients treated at a single tertiary center. Results: Calibration plots show good model calibration. Dynamic C‐indices suggest that the model can discriminate between high‐ and low‐risk patients. The dynamic C‐indices at 0, 1, 2, 3, 4, and 5 years after surgery were equal to 0.697, 0.790, 0.822, 0.818, 0.812, and 0.827, respectively. Conclusion: Results from the external validation show that the dynamic PERSARC model is reliable in predicting the probability of surviving an additional 5 years from a specific prediction time point during follow‐up. The model combines patient‐, treatment‐specific and time‐dependent variables such as local recurrence and distant metastasis to provide accurate survival predictions throughout follow‐up and is available through the PERSARC app.Peer reviewe