The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Direct and mediated associations between religious coping, spirituality, and youth violence in El Salvador

OBJECTIVE: To examine the direct and mediated relationships between religious coping, spirituality, social developmental factors, and violence among high-risk and gang-involved youth in a high-crime, Latin American country. METHODS: Using a community sample of 290 high-risk and gang-involved youth in San Salvador, El Salvador, structural equation modeling was employed to examine the relationships between religious coping, spirituality, social developmental factors (e.g., antisocial bond and antisocial beliefs), and violence. RESULTS: Religious coping (β = - 0.14, P < 0.05) and spirituality (β = - 0.20, P < 0.01) were both significantly associated with antisocial bond. Antisocial bond, in turn, was directly associated with violence (β = 0.70, P < 0.001) and was associated with antisocial beliefs (β = 0.54, P < 0.001); however, the path from antisocial beliefs to violence was not statistically significant. No direct paths were identified from religiosity and spirituality to violence. The goodness-of-fit statistics (root mean square error of approximation, 0.034; comparative fit index, 0.974; and Tucker-Lewis index, 0.966) suggest that the final model had acceptable fit. CONCLUSIONS: This study is among the first to shed light on the relationship between religiosity, spirituality, and youth violence in the Latin American context. Elevated levels of religious coping and spirituality are associated with less antisocial bonding, which, in turn, is associated with lower levels of violent behavior among high-risk and gang-involved Salvadoran youth. Study findings suggest that religious coping and spirituality are indirectly protective for youth violence among this high-risk population

Truancy in the United States: Examining temporal trends and correlates by race, age, and gender

Background: Truancy has long been regarded a common problem in urgent need of effective intervention. Knowledge about factors associated with truancy can guide the development and implementation of interventions. Method: This paper examined trends in truancy rates between 2002–2014 and correlates of truancy across racial/ethnic groups. Variables of interest included sociodemographic factors (e.g., age, gender, socio-economic background), behavioral factors (e.g., substance use, violence), and psychosocial factors (e.g., academic engagement, grades, parental control). Using data from a large sample of adolescents (n=209,393; 12–17 years) we estimated truancy prevalence rates and examined trends and correlates via regression analyses. Results: Truancy rates remained constant between 2002 (10.8%) and 2014 (11.1%). Rates were highest among older youth, females, and Hispanic youth. For all racial/ethnic groups, truancy was significantly correlated with alcohol and marijuana use, fighting, the propensity to take risks, and lower academic engagement and school grades. Other factors were differentially associated with racial/ethnic groups. This divergence in risk patterns for different racial/ethnic groups points to some heterogeneity amongst truant youth. Discussion: Despite truancy reduction efforts, truancy rates have remained stable. Efforts to prevent truancy and to intervene with truant youth may need to target risk factors more prevalent in specific racial/ethnic groups

Search for singly and pair-produced leptoquarks coupling to third-generation fermions in proton-proton collisions at root s=13 TeV

A search for leptoquarks produced singly and in pairs in proton-proton collisions is presented. We consider the leptoquark (LQ) to be a scalar particle of charge -1/3e coupling to a top quark plus a tau lepton (t tau) or a bottom quark plus a neutrino (b nu), or a vector particle of charge +2/3e, coupling to t nu or b tau. These choices are motivated by models that can explain a series of anomalies observed in the measurement of B meson decays. In this analysis the signatures t tau nu b and t tau nu are probed, using data recorded by the CMS experiment at the CERN LHC at root s = 13 TeV and that correspond to an integrated luminosity of 137 fb(-1). These signatures have not been previously explored in a dedicated search. The data are found to be in agreement with the standard model prediction. Lower limits at 95% confidence level are set on the LQ mass in the range 0.98-1.73 TeV, depending on the LQ spin and its coupling lambda to a lepton and a quark, and assuming equal couplings for the two LQ decay modes considered. These are the most stringent constraints to date on the existence of leptoquarks in this scenario. (C) 2021 The Author(s). Published by Elsevier B.V.Peer reviewe

Spectroscopy of 161Hf from low to high spin

Excited states in the neutron-deficient nucleus 161 72Hf89 have been populated using the 118Sn(48Ti,5n) 161Hf and 110Pd(56Fe,5n) 161Hf fusion-evaporation reactions at 240 and 270 MeV, respectively. The level scheme for 161Hf has been extended with the observation of new band structures and an I π = (13/2+) isomeric state with a half-life of 4.8(2) μs has been identified. The decay path from this isomer to the (7/2−) ground state is established. The yrast band, based on the (13/2+) isomeric state, is extended up to (73/2+) and side band structures are identified up to (69/2−) and (55/2−). Quasiparticle assignments for these rotational structures are made on the basis of their alignment properties and Woods-Saxon cranked shell-model calculations.peerReviewe