Are Tumor Marker Tests Applied Appropriately in Clinical Practice? A Healthcare Claims Data Analysis.

Tumor markers (TM) are crucial in the monitoring of cancer treatment. However, inappropriate requests for screening reasons have a high risk of false positive and negative findings, which can lead to patient anxiety and unnecessary follow-up examinations. We aimed to assess the appropriateness of TM testing in outpatient practice in Switzerland. We conducted a retrospective cohort study based on healthcare claims data. Patients who had received at least one out of seven TM tests (CEA, CA19-9, CA125, CA15-3, CA72-4, Calcitonin, or NSE) between 2018 and 2021 were analyzed. Appropriate determinations were defined as a request with a corresponding cancer-related diagnosis or intervention. Appropriateness of TM determination by patient characteristics and prescriber specialty was estimated by using multivariate analyses. A total of 51,395 TM determinations in 36,537 patients were included. An amount of 41.6% of all TM were determined appropriately. General practitioners most often determined TM (44.3%) and had the lowest number of appropriate requests (27.8%). A strong predictor for appropriate determinations were requests by medical oncologists. A remarkable proportion of TM testing was performed inappropriately, particularly in the primary care setting. Our results suggest that a considerable proportion of the population is at risk for various harms associated with misinterpretations of TM test results

Pyrrolizidines for direct air capture and CO2 conversion

Greenhouse gases such as CO2 strongly contribute to the rising temperatures of our planet, but as long as our society is dependent on fossil fuels, this trend will even increase in the near future. Therefore, CO2 capture and subsequent utilization constitute an approach for decarbonization and CO2 mitigation, and for this purpose, amine scrubbing remains the industrially most established process. In this article, we describe the CO2 capture-ability of pyrrolizidine-based diamines, a scaffold with remarkably good properties to fulfill this challenge. We observed fast equimolar CO2-uptake, as well as high stability of these compounds during multiple capture and release-cycles. In addition, the amines could be utilized for direct air capture. Finally, we demonstrate the utility of the pyrrolizidine absorbents in the reduction of CO2 and for the formation of oxazolidinones

Atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from Post Anesthesia Care Unit.

BACKGROUND Obese patients frequently develop pulmonary atelectasis upon general anesthesia. The risk is increased during laparoscopic surgery. This prospective, observational single-center study evaluated atelectasis dynamics using Electric Impedance Tomography (EIT) in patients undergoing laparoscopic bariatric surgery. METHODS We included adult patients with ASA physical status I-IV and a BMI of ≥40. Exclusion criteria were known severe pulmonary hypertension, home oxygen therapy, heart failure, and recent pulmonary infections. The primary outcome was the proportion of poorly ventilated lung regions (low tidal variation areas) and the global inhomogeneity (GI) index assessed by EIT before discharge from the Post Anesthesia Care Unit compared to these same measures prior to initiation of anesthesia. RESULTS The median (IQR) proportion of low tidal variation areas at the different analysis points were T1 10.8% [3.6-15.1%] and T5 10.3% [2.6-18.9%], and the mean difference was -0.7% (95% CI: -5.8% -4.5%), i.e., lower than the predefined non-inferiority margin of 5% (p = 0.022). There were no changes at the four additional time points compared to T1 or postoperative pulmonary complications during the 14 days following the procedure. CONCLUSION We found that obese patients undergoing laparoscopic bariatric surgery do not leave the Post Anesthesia Care Unit with increased low tidal variation areas compared to the preoperative period

Temporary Employment, Permanent Stigma? Perceptions of Temporary Agency Workers Across Low- and High-Skilled Jobs

Research on temporary agency work emphasizes that temporary agency workers (TAWs), particularly those in low-skilled jobs associated with precariousness and low social prestige, are likely to be exposed to poor treatment, as well as stigmatization. On the contrary, stigmatization of TAWs in high-skilled jobs has not been treated in much detail in previous studies. Literature provides an incomplete picture of stigmatization within the broader field of temporary employment regarding the focus on low-skilled jobs. Hence, the present qualitative study is based on data from interviews of a heterogeneous sample of TAWs employed in low- and high-skilled jobs in Germany. By using and modifying Boyce and colleagues’ (2007) model of stigmatization, the study shows that stigmatizing treatment towards TAWs occurs across all skill levels, although the intensity and form of those experiences, as well as coping strategies, differ. Thereby, this study contributes to a more differentiated and skill level-specific understanding of how TAWs perceive and cope with stigmatization linked to their employment status. It also provides an important opportunity to advance Boyce and colleagues’ (2007) complex model of TAW stigmatization with empirical underpinnings

Glucose metabolism determines resistance of cancer cells to bioenergetic crisis after cytochrome-c release

How can cancer cells survive the consequences of cyt-c release? Huber et al provide a quantitative analysis of the protective role of enhanced glucose utilization in cancer cells and investigate the impact of cell-to-cell heterogeneity in mitochondrial bioenergetics

The Interplay between Child Maltreatment and Stressful Life Events during Adulthood and Cardiovascular Problems—A Representative Study

Psychological stress is a major risk factor for cardiovascular diseases. While the relevance of early life stress, such as that which is due to child maltreatment (CM), is well known to impact individual stress responses in the long-term, and data on the interplay between CM and stressful events in adulthood on cardiovascular health are sparse. Here, we aimed to assess how stressful life events in adulthood are associated with cardiovascular health infarction in later life and whether this association is independent of CM. In a cross-sectional design, a probability sample of the German population above the age of 14 was drawn using different sampling steps. The final sample included 2510 persons (53.3% women, mean age: 48.4 years). Participants were asked about sociodemographic factors, adult life events, CM, and health conditions in adulthood. Results indicate that the number of experienced adverse life events in adulthood is associated with significantly increased odds for obesity (Odds Ration (OR)women = 1.6 [1.3; 2.0], ORmen = 1.4 [1.1; 1.9]), diabetes (ORwomen = 1.5 [1.1; 2.1], ORmen = 1.5 [1.1; 2.3]) and myocardial infarction (ORwomen = 2.1 [1.0; 4.3], ORmen = 1.8 [1.1; 2.8]). This association is not moderated by the experience of CM, which is associated with cardiovascular problems independently. Taken together, adult stressful life events and CM are significantly and independently associated with cardiovascular health in men and women in the German population in a dose-dependent manner. General practitioners, cardiologists and health policy-makers should be aware of this association between psychosocial stressors during childhood and adulthood and cardiovascular health