Perioperative events influence cancer recurrence risk after surgery.

Surgery is a mainstay treatment for patients with solid tumours. However, despite surgical resection with a curative intent and numerous advances in the effectiveness of (neo)adjuvant therapies, metastatic disease remains common and carries a high risk of mortality. The biological perturbations that accompany the surgical stress response and the pharmacological effects of anaesthetic drugs, paradoxically, might also promote disease recurrence or the progression of metastatic disease. When cancer cells persist after surgery, either locally or at undiagnosed distant sites, neuroendocrine, immune, and metabolic pathways activated in response to surgery and/or anaesthesia might promote their survival and proliferation. A consequence of this effect is that minimal residual disease might then escape equilibrium and progress to metastatic disease. Herein, we discuss the most promising proposals for the refinement of perioperative care that might address these challenges. We outline the rationale and early evidence for the adaptation of anaesthetic techniques and the strategic use of anti-adrenergic, anti-inflammatory, and/or antithrombotic therapies. Many of these strategies are currently under evaluation in large-cohort trials and hold promise as affordable, readily available interventions that will improve the postoperative recurrence-free survival of patients with cancer

School interventions for the social inclusion of school-age learners on the autism spectrum: Review of the evidence and future areas of inquiry

Despite the internationally rising number of students with autism spectrum conditions (ASC) in inclusive settings, their difficulties in building and maintaining social relationships in schools remain a persisting challenge, contributing to detrimental educational outcomes, which in turn may lead to their transfer in more segregated environments. In response to this reality and with the aim to enhance the social and academic benefits of inclusion for students with ASC, this book chapter will discuss and evaluate existing empirical research based on interventions occurring in classrooms across preschool, primary school, and secondary school. Specifically, this review will present a synthesis of the research literature on educational approaches and strategies which have been implemented successfully in general education classrooms with the participation of teachers and peers to improve the social understanding and social interaction skills of students with ASC. Furthermore, this chapter will endeavor to identify the barriers for the application of classroom interventions for the social success of children with ASC in inclusive settings as well as the limitations and future needs in this field of applied research

B Cell Immunosenescence

Innate and adaptive immune responses decline with age, leading to greater susceptibility to infectious diseases and reduced responses to vaccines. Diseases are more severe in old than in young individuals and have a greater impact on health outcomes such as morbidity, disability, and mortality. Aging is characterized by increased low-grade chronic inflammation, so-called inflammaging, that represents a link between changes in immune cells and a number of diseases and syndromes typical of old age. In this review we summarize current knowledge on age-associated changes in immune cells with special emphasis on B cells, which are more inflammatory and less responsive to infections and vaccines in the elderly. We highlight recent findings on factors and pathways contributing to inflammaging and how these lead to dysfunctional immune responses. We summarize recent published studies showing that adipose tissue, which increases in size with aging, contributes to inflammaging and dysregulated B cell function