Risk factors for 30-day soft tissue complications after pelvic sarcoma surgery:A National Surgical Quality Improvement Program study

Introduction: Soft tissue (ST) complications after resection of bone and ST sarcomas of the pelvis occur more frequently than in appendicular tumors. We sought to identify risk factors for complications within 30 days of surgery. Methods: The National Surgical Quality Improvement Program database was used for this study. Patients with sarcomas of bone and ST of the pelvis were retrieved using Current Procedural Terminology and International Classification of Diseases codes. Outcomes assessed were ST complications, overall complication rates, 30-day reoperation, and mortality. Results: A total of 770 patients with pelvic bone and ST sarcoma were included. The ST complication rate was 12.6%, including 4.9% superficial and 4.7% deep surgical site infections. Higher ST complication rates were seen in patients &gt;30 years, with partially dependent health status, hematocrit &lt;30%, bone tumors, tumor &gt;5 cm, amputation procedures, and longer operative times. ST complication rates were 1.5 and 3 times higher in pelvic sarcoma surgeries than in the lower and upper extremities, respectively. Age &gt;30 years (odds ratio [OR] = 5.07), hematocrit &lt;30% (OR = 1.84), operative time 1–3 h (OR = 2.97), and &gt;3 h (OR = 4.89) were risk factors for ST complications. Conclusion: One in nine patients with pelvic sarcoma surgery will develop ST complications within 30 days. Risk factors for ST complications were age &gt;30, hematocrit &lt;30%, and longer operative time.</p

On the Detection of a Scalar Stochastic Background of Gravitational Waves

In the near future we will witness the coming to a full operational regime of laser interferometers and resonant mass detectors of spherical shape. In this work we study the sensitivity of pairs of such gravitational wave detectors to a scalar stochastic background of gravitational waves. Our computations are carried out both for minimal and non minimal coupling of the scalar fields.Comment: 25 pages, 3 figure

Sheep reproductive management

Objetive: Describe some reproductive management programs that have made it possible to increase the productive efficiency of sheep. Desing/methodology/approach: Description of the main hormones and their application in sheep reproductive management protocols. The topics are addressed from academic references and use in sheep reproductive protocols in the Reproduction Laboratory for Sheep and Goat of the Colegio de Postgraduados, Mexico. Results: The use of hormones, socio-sexual strategies, reproductive protocols and techniques are tools that improve the reproductive efficiency of sheep during the reproductive and seasonal anestrus season. Study limitations/implications: The basic techniques of reproductive management and protocols in sheep are mostly available, however they still have a wide margin for improvement, which requires multiple efforts that involve all participating sectors, such as the primary sector, institutions public and private. Findings/conclusions: Reproductive management is a pillar of great importance in animal production, which is why it is essential to implement it to improve the reproductive and productive efficiency of the herd.Objective: To describe some reproductive management programs that allow increasing the productive efficiency of ewes. Design/methodology/approach: Description of the main hormones and their application in sheep reproductive management protocols. The subjects are reviewed based on academic references as well as on their use in sheep reproductive protocols at the Sheep and Goat Reproduction Laboratory of the Colegio de Postgraduados, Mexico. Results: Hormones, socio-sexual strategies, reproductive protocols and techniques are tools that improve the reproductive efficiency of ewes during the reproductive season and seasonal anestrus. Study limitations/implications: The basic techniques of reproductive management and protocols in sheep are mostly available, however, they still have room for improvement, therefore, multiple efforts involving all participants, such as the primary sector, public and private institutions, are required. Findings/conclusions: Reproductive management is an important pillar for animal production; thus its implementation is fundamental to improve the reproductive and productive efficiency of a her

Os sistemas agroflorestais como alternativa de sustentabilidade em ecossistemas de várzea no Amazonas.

Os sistemas agroflorestais (SAFs) representam uma alternativa agroecológica de produção, sob regime sustentável, para os agricultores familiares na várzea dos Rios Solimões/Amazonas, principalmente no que se refere ao manejo florestal, à diversidade de produtos e à geração de renda. Diante disso, o objetivo deste trabalho foi compreender as diferentes formas de apropriação e de manejo dos recursos naturais através dos SAFs, nos subsistemas roça, sítio e lagos, como componente para a sustentabilidade dos agricultores familiares da localidade Costa da Terra Nova, município do Careiro da Várzea, Amazonas. O método empregado foi o Estudo de Caso com aplicação de questionários, entrevistas e observação participante. A produção familiar na Costa da Terra Nova é representada pelos SAFs, constituído pelos os subsistemas: roça quintal e lago, que proporcionam produtos tanto para subsistência quanto para comercialização local, e estabelecendo a agricultura como fundamental atividade na localidade. O principal produto para comercialização é obtido das hortaliças cultivadas na época da vazante no subsistema roça nas comunidades São Francisco e Nossa Senhora da Conceição; e do extrativismo pesqueiro no subsistema lago, na época da cheia, principalmente na comunidade São José. A criação de animal se dá no subsistema sítio e é apenas para subsistência, sendo as aves e os suínos os principais animais domésticos criados nas três comunidades. Portanto os SAFs tradicionais, constituídos pelos subsistemas, roça, sitio e lago, são responsáveis pela sustentabilidade socioeconômica da localidade pesquisada, servindo, como alternativa agrícola melhor adaptada às condições locais das áreas de várzea na Amazônia

Age at symptom onset and death and disease duration in genetic frontotemporal dementia : an international retrospective cohort study

Background: Frontotemporal dementia is a heterogenous neurodegenerative disorder, with about a third of cases being genetic. Most of this genetic component is accounted for by mutations in GRN, MAPT, and C9orf72. In this study, we aimed to complement previous phenotypic studies by doing an international study of age at symptom onset, age at death, and disease duration in individuals with mutations in GRN, MAPT, and C9orf72. Methods: In this international, retrospective cohort study, we collected data on age at symptom onset, age at death, and disease duration for patients with pathogenic mutations in the GRN and MAPT genes and pathological expansions in the C9orf72 gene through the Frontotemporal Dementia Prevention Initiative and from published papers. We used mixed effects models to explore differences in age at onset, age at death, and disease duration between genetic groups and individual mutations. We also assessed correlations between the age at onset and at death of each individual and the age at onset and at death of their parents and the mean age at onset and at death of their family members. Lastly, we used mixed effects models to investigate the extent to which variability in age at onset and at death could be accounted for by family membership and the specific mutation carried. Findings: Data were available from 3403 individuals from 1492 families: 1433 with C9orf72 expansions (755 families), 1179 with GRN mutations (483 families, 130 different mutations), and 791 with MAPT mutations (254 families, 67 different mutations). Mean age at symptom onset and at death was 49\ub75 years (SD 10\ub70; onset) and 58\ub75 years (11\ub73; death) in the MAPT group, 58\ub72 years (9\ub78; onset) and 65\ub73 years (10\ub79; death) in the C9orf72 group, and 61\ub73 years (8\ub78; onset) and 68\ub78 years (9\ub77; death) in the GRN group. Mean disease duration was 6\ub74 years (SD 4\ub79) in the C9orf72 group, 7\ub71 years (3\ub79) in the GRN group, and 9\ub73 years (6\ub74) in the MAPT group. Individual age at onset and at death was significantly correlated with both parental age at onset and at death and with mean family age at onset and at death in all three groups, with a stronger correlation observed in the MAPT group (r=0\ub745 between individual and parental age at onset, r=0\ub763 between individual and mean family age at onset, r=0\ub758 between individual and parental age at death, and r=0\ub769 between individual and mean family age at death) than in either the C9orf72 group (r=0\ub732 individual and parental age at onset, r=0\ub736 individual and mean family age at onset, r=0\ub738 individual and parental age at death, and r=0\ub740 individual and mean family age at death) or the GRN group (r=0\ub722 individual and parental age at onset, r=0\ub718 individual and mean family age at onset, r=0\ub722 individual and parental age at death, and r=0\ub732 individual and mean family age at death). Modelling showed that the variability in age at onset and at death in the MAPT group was explained partly by the specific mutation (48%, 95% CI 35\u201362, for age at onset; 61%, 47\u201373, for age at death), and even more by family membership (66%, 56\u201375, for age at onset; 74%, 65\u201382, for age at death). In the GRN group, only 2% (0\u201310) of the variability of age at onset and 9% (3\u201321) of that of age of death was explained by the specific mutation, whereas 14% (9\u201322) of the variability of age at onset and 20% (12\u201330) of that of age at death was explained by family membership. In the C9orf72 group, family membership explained 17% (11\u201326) of the variability of age at onset and 19% (12\u201329) of that of age at death. Interpretation: Our study showed that age at symptom onset and at death of people with genetic frontotemporal dementia is influenced by genetic group and, particularly for MAPT mutations, by the specific mutation carried and by family membership. Although estimation of age at onset will be an important factor in future pre-symptomatic therapeutic trials for all three genetic groups, our study suggests that data from other members of the family will be particularly helpful only for individuals with MAPT mutations. Further work in identifying both genetic and environmental factors that modify phenotype in all groups will be important to improve such estimates. Funding: UK Medical Research Council, National Institute for Health Research, and Alzheimer's Society

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true