Anesthesia Options and the Recurrence of Cancer: What We Know so Far?

Surgery is a critical period in the survival of patients with cancer. While resective surgery of primary tumors has shown to prolong the life of these patients, it can also promote mechanisms associated with metastatic progression. During surgery, patients require general and sometimes local anesthetics that also modulate mechanisms that can favor or reduce metastasis. In this narrative review, we summarized the evidence about the impact of local, regional and general anesthesia on metastatic mechanisms and the survival of patients. The available evidence suggests that cancer recurrence is not significantly impacted by neither regional anesthesia nor volatile or total intravenous anesthesia

Catalytic surface promotion of highly active La0.85Sr0.15Cr0.8Ni0.2O3-delta anodes for La5.6WO11.4-delta based proton conducting fuel cells

[EN] La0.85Sr0.15CrO3-delta (LSC), La0.85Sr0.15Cr0.8Ni0.2O3-delta (LSCN) and LSCN infiltrated with Ni nanoparticles were tested as anodes for symmetrical cells based on La5.6WO11.4-delta (LWO) protonic electrolyte. These chromite-based electrode materials are compatible with LWO material, in contrast to the widely used NiO. Under typical anode reducing conditions, Ni is segregated from the LSCN lattice on the grain surface as metallic Ni nanoparticles, which are proved to be compatible with LWO in reducing conditions. These Ni nanoparticles become the catalytic active sites for the H-2 oxidation reaction in proton conducing anodes and the electrode performance is substantially improved regarding to pure LSC. Ni nanoparticle infiltration further improves the catalytic promotion of the anode, reducing the polarization resistance (R-p) previously limited by low frequency surface related processes. Indeed, the R-p, values achieved for LSCN infiltrated with Ni, e.g. 0.47 Omega cm(2) at 700 degrees C, suggest the practical application of this kind of anodes in proton conducting solid oxide fuel cells (PC-SOFC). (C) 2013 Elsevier B.V. All rights reserved.Funding from European Union (FP7 Project EFFIPRO - Grant Agreement 227560), the Spanish Government (ENE2011-24761, SEV-2012-0267 and CSIC Intramural 2008801093 grants) is kindly acknowledged. The authors thank M. Fabuel for sample preparation.Solis Díaz, C.; Balaguer Ramirez, M.; Bozza, F.; Bonanos, N.; Serra Alfaro, JM. (2014). Catalytic surface promotion of highly active La0.85Sr0.15Cr0.8Ni0.2O3-delta anodes for La5.6WO11.4-delta based proton conducting fuel cells. Applied Catalysis B Environmental. 147:203-207. https://doi.org/10.1016/j.apcatb.2013.08.04420320714

Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

In addition to attaining complete or near complete cytoreduction, the instillation of select heated chemotherapeutic agents into the abdominal cavity has offered a chance for cure or longer survival inpatients with peritoneal surface malignancies. While the heating of chemotherapeutic agents enhances cytotoxicity, the resulting systemic hyperthermia has been associated with an increased risk of severe hyperthermia and its associated complications. Factors that have been associated with an increased risk of severe hyperthermia include intraoperative blood transfusions and longer perfusion duration. However, the development of severe hyperthermia still remains largely unpredictable. Thus, at several institutions, cooling protocols are employed during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Cooling protocols for CRS-HIPEC are not standardized and may be associated with episodes of severe hyperthermia or alternatively hypothermia. In theory, excessive cooling could result in a decreased effectiveness of the intraperitoneal chemotherapeutic agents. This presumption has been supported by a recent study of 214 adults undergoing CRS-HIPEC, where failure to attain a temperature of 38° C at the end of chemo-perfusion was associated with worse survival. Although not statistically significant, failure to maintain a temperature of 38° C for at least 30 minutes was associated with worse survival. Although studies are limited in this regard, the importance of maintaining a steady state of temperature during the hyperthermic phase of intraperitoneal chemotherapy administration cannot be disregarded. The following article describes the processes and physiological mechanisms responsible for hyperthermia during CRS-HIPEC. The challenges associated with temperature management during CRS-HIPEC and methods to avoid severe hypothermia and hyperthermia are also described

The N-fixing legume Periandra mediterranea constrains the invasion of an exotic grass (Melinis minutiflora P. Beauv) by altering soil N cycling

Melinis minutiflora is an invasive species that threatens the biodiversity of the endemic vegetation of the campo rupestre biome in Brazil, displacing the native vegetation and favouring fire spread. As M. minutiflora invasion has been associated with a high nitrogen (N) demand, we assessed changes in N cycle under four treatments: two treatments with contrasting invasion levels (above and below 50%) and two un-invaded control treatments with native vegetation, in the presence or absence of the leguminous species Periandra mediterranea. This latter species was considered to be the main N source in this site due to its ability to fix N2 in association with Bradyrhizobia species. Soil proteolytic activity was high in treatments with P. mediterranea and in those severely invaded, but not in the first steps of invasion. While ammonium was the N-chemical species dominant in plots with native species, including P.mediterranea, soil nitrate prevailed only in fully invaded plots due to the stimulation of the nitrifying bacterial (AOB) and archaeal (AOA) populations carrying the amoA gene. However, in the presence of P. mediterranea, either in the beginning of the invasion or in uninvaded plots, we observed an inhibition of the nitrifying microbial populations and nitrate formation, suggesting that this is a biotic resistance strategy elicited by P. mediterranea to compete with M. minutiflora. Therefore, the inhibition of proteolytic activity and the nitrification process were the strategies elicited by P.mediterranea to constrain M.munitiflora invasion

The informal social support for autonomy and dependence in pain inventory Spanish version

Social support plays a crucial role in the quality of life of people with chronic pain. The Informal Social Support for Autonomy and Dependence in Pain Inventory assesses two functions of received social support: the promotion of autonomy and the promotion of dependence. The aim of this cross-sectional study was to adapt this instrument for its use in the Spanish population. The sample comprised 256 individuals with chronic pain. Participants were recruited through two local associations of people with fibromyalgia, a physiotherapy unit and a hospital pain unit. The data were collected in Spain between October 2018 and January 2020. The structure of the questionnaire was analysed using confirmatory factor analysis, average variance extracted, composite reliability and internal consistency indexes, and inter-correlations between the scales. The criterion-related validity of the instrument was analysed by investigating its relationship with pain intensity, positive and negative affect, daily functioning, activity impairment, wellbeing and satisfaction with life. The structure with the best fit had four related factors: emotional social support for the promotion of autonomy; instrumental social support for the promotion of autonomy; emotional social support for the promotion of dependence and instrumental social support for the promotion of dependence. The scales showed adequate internal consistency. An association was found between higher levels of instrumental social support for the promotion of dependence and higher levels of pain-related disability and decreased daily functioning. An association was also found between the promotion of autonomy and increased satisfaction with life. The Spanish version of the inventory shows appropriate psychometric properties. In the setting of disability prevention, this instrument is useful in assessing the support relationships between people with chronic pain and their relatives.This study was supported by grants from the Spanish Ministry of Science and Innovation (PID2019-106086RB-I00) and the Regional Government of Andalusia (HUM-566). Funding for open access charge: Universidad de Málaga / CBUA

A Neutron Star Binary Merger Model for GW170817/GRB170817a/SSS17a

The merging neutron star gravitational wave event GW170817 has been observed throughout the entire electromagnetic spectrum from radio waves to $\gamma$-rays. The resulting energetics, variability, and light curves are shown to be consistent with GW170817 originating from the merger of two neutron stars, in all likelihood followed by the prompt gravitational collapse of the massive remnant. The available $\gamma$-ray, X-ray and radio data provide a clear probe for the nature of the relativistic ejecta and the non-thermal processes occurring within, while the ultraviolet, optical and infrared emission are shown to probe material torn during the merger and subsequently heated by the decay of freshly synthesized $r$-process material. The simplest hypothesis that the non-thermal emission is due to a low-luminosity short $\gamma$-ray burst (sGRB) seems to agree with the present data. While low luminosity sGRBs might be common, we show here that the collective prompt and multi-wavelength observations are also consistent with a typical, powerful sGRB seen off-axis. Detailed follow-up observations are thus essential before we can place stringent constraints on the nature of the relativistic ejecta in GW170817.Comment: 9 pages, 5 figures, accepted to ApJ Letter

Millimagnitude Photometry for Transiting Extrasolar Planetary Candidates IV: The Puzzle of the Extremely Red OGLE-TR-82 Primary Solved

We present precise new V, I, and K-band photometry for the planetary transit candidate star OGLE-TR-82. Good seeing V-band images acquired with VIMOS instrument at ESO VLT allowed us to measure V=20.6+-0.03 mag star in spite of the presence of a brighter neighbour about 1" away. This faint magnitude answers the question why it has not been possible to measure radial velocities for this object. One transit of this star has been observed with GMOS-S instrument of GEMINI-South telescope in i and g-bands. The measurement of the transit allows us to verify that this is not a false positive, to confirm the transit amplitude measured by OGLE, and to improve the ephemeris. The transit is well defined in i-band light curve, with a depth of A_i=0.034 mag. It is however, less well defined, but deeper (A_g=0.1 mag) in the g-band, in which the star is significantly fainter. The near-infrared photometry obtained with SofI array at the ESO-NTT yields K=12.2+-0.1 and V-K=8.4+-0.1, so red that it is unlike any other transit candidate studied before. Due to the extreme nature of this object, we have not yet been able to measure velocities for this star, but based on the new data we consider two different possible configurations:(1) a nearby M7V star, or (2) a blend with a very reddened distant red giant. The nearby M7V dwarf hypothesis would give a radius for the companion of R_p=0.3+-0.1 R_J, i.e. the size of Neptune. Quantitative analysis of near-IR spectroscopy finally shows that OGLE-TR-82 is a distant, reddened metal poor early K giant. This result is confirmed by direct comparison with stellar templates that gives the best match for a K3III star. Therefore, we discard the planetary nature of the companion. Based on all the new data, we conclude that this system is a main-sequence binary blended with a background red giant.Comment: 26 pages, 9 figures, ApJ accepte

Multi-task learning for joint weakly-supervised segmentation and aortic arch anomaly classification in fetal cardiac MRI

Congenital Heart Disease (CHD) is a group of cardiac malformations present already during fetal life, representing the prevailing category of birth defects globally. Our aim in this study is to aid 3D fetal vessel topology visualisation in aortic arch anomalies, a group which encompasses a range of conditions with significant anatomical heterogeneity. We present a multi-task framework for automated multi-class fetal vessel segmentation from 3D black blood T2w MRI and anomaly classification. Our training data consists of binary manual segmentation masks of the cardiac vessels' region in individual subjects and fully-labelled anomaly-specific population atlases. Our framework combines deep learning label propagation using VoxelMorph with 3D Attention U-Net segmentation and DenseNet121 anomaly classification. We target 11 cardiac vessels and three distinct aortic arch anomalies, including double aortic arch, right aortic arch, and suspected coarctation of the aorta. We incorporate an anomaly classifier into our segmentation pipeline, delivering a multi-task framework with the primary motivation of correcting topological inaccuracies of the segmentation. The hypothesis is that the multi-task approach will encourage the segmenter network to learn anomaly-specific features. As a secondary motivation, an automated diagnosis tool may have the potential to enhance diagnostic confidence in a decision support setting. Our results showcase that our proposed training strategy significantly outperforms label propagation and a network trained exclusively on propagated labels. Our classifier outperforms a classifier trained exclusively on T2w volume images, with an average balanced accuracy of 0.99 (0.01) after joint training. Adding a classifier improves the anatomical and topological accuracy of all correctly classified double aortic arch subjects.Comment: Accepted for publication at the Journal of Machine Learning for Biomedical Imaging (MELBA) https://melba-journal.org/2023:01

Electromagnetic Evidence that SSS17a is the Result of a Binary Neutron Star Merger

11 hours after the detection of gravitational wave source GW170817 by the Laser Interferometer Gravitational-Wave Observatory and Virgo Interferometers, an associated optical transient SSS17a was discovered in the galaxy NGC 4993. While the gravitational wave data indicate GW170817 is consistent with the merger of two compact objects, the electromagnetic observations provide independent constraints of the nature of that system. Here we synthesize all optical and near-infrared photometry and spectroscopy of SSS17a collected by the One-Meter Two-Hemisphere collaboration. We find that SSS17a is unlike other known transients. The source is best described by theoretical models of a kilonova consisting of radioactive elements produced by rapid neutron capture (the r-process). We find that SSS17a was the result of a binary neutron star merger, reinforcing the gravitational wave result.Comment: 21 pages, 4 figures, accepted to Scienc