Paleobiology of titanosaurs: reproduction, development, histology, pneumaticity, locomotion and neuroanatomy from the South American fossil record

Fil: García, Rodolfo A.. Instituto de Investigación en Paleobiología y Geología. Museo Provincial Carlos Ameghino. Cipolletti; ArgentinaFil: Salgado, Leonardo. Instituto de Investigación en Paleobiología y Geología. General Roca. Río Negro; ArgentinaFil: Fernández, Mariela. Inibioma-Centro Regional Universitario Bariloche. Bariloche. Río Negro; ArgentinaFil: Cerda, Ignacio A.. Instituto de Investigación en Paleobiología y Geología. Museo Provincial Carlos Ameghino. Cipolletti; ArgentinaFil: Carabajal, Ariana Paulina. Museo Carmen Funes. Plaza Huincul. Neuquén; ArgentinaFil: Otero, Alejandro. Museo de La Plata. Universidad Nacional de La Plata; ArgentinaFil: Coria, Rodolfo A.. Instituto de Paleobiología y Geología. Universidad Nacional de Río Negro. Neuquén; ArgentinaFil: Fiorelli, Lucas E.. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica. Anillaco. La Rioja; Argentin

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Everolimus Plus Exemestane in Advanced Breast Cancer: Safety Results of the BALLET Study on Patients Previously Treated Without and with Chemotherapy in the Metastatic Setting

BACKGROUND: The BALLET study was an open-label, multicenter, expanded access study designed to allow treatment with everolimus plus exemestane in postmenopausal women with hormone receptor-positive metastatic breast cancer progressed following prior endocrine therapy. A post hoc analysis to evaluate if previous chemotherapy in the metastatic setting affects the safety profile of the combination regimen of everolimus and exemestane was conducted on the Italian subset, as it represented the major part of the patients enrolled (54%). PATIENTS AND METHODS: One thousand one hundred and fifty-one Italian patients were included in the present post hoc analysis, which focused on two sets of patients: patients who never received chemotherapy in the metastatic setting (36.1%) and patients who received at least one chemotherapy treatment in the metastatic setting (63.9%). RESULTS: One thousand one hundred and sixteen patients (97.0%) prematurely discontinued the study drug, and the main reasons reported were disease progression (39.1%), local reimbursement of everolimus (31.1%), and adverse events (AEs) (16.1%). The median duration of study treatment exposure was 139.5 days for exemestane and 135.0 days for everolimus. At least one AE was experienced by 92.5% of patients. The incidence of everolimus-related AEs was higher (83.9%) when compared with those that occurred with exemestane (29.1%), and the most commonly reported everolimus-related AE was stomatitis (51.3%). However, no significant difference in terms of safety related to the combination occurred between patients without and with chemotherapy in the metastatic setting. CONCLUSION: Real-life data of the Italian patients BALLET-related cohort were an adequate setting to state that previous chemotherapy did not affect the safety profile of the combination regimen of everolimus and exemestane. The Oncologist 2017;22:1-8Implications for Practice: With the advent of new targeted agents for advanced or metastatic breast cancer, multiple lines of therapy may be possible, and components of the combined regimens can overlap from one line to another. Thus, it is important to assess even the potential of cumulative and additive toxic effects among the drugs. Previous chemotherapy did not affect the safety profile of the combination regimen of everolimus and exemestane. The continuous monitoring of the safety signals of this drug combination from general clinical practice is important, in particular for stomatitis

Paleobiología de Titanosaurios de Sudamérica: reproducción, desarrollo, histología, neumaticidad, locomoción y neuroanatomía

Much of the current paleobiological knowledge on titanosaur sauropods was attained in just the last fifteen years, in particular that related to reproductive and developmental biology. Recent years have also seen progress on other poorly explored topics, such as pneumaticity, muscle architecture and locomotion, and endocast reconstruction and associated structures. Some titanosaurs laid numerous, relatively small Megaloolithidae eggs (with diameters ranging from 12 to 14 cm) in nests dug In the ground and, as known from the South American records, probably eggs of the multispherulitic morphotype. During ontogeny, certain titanosaurs displayed some variations in cranial morphology, some of them likely associated with the differing feeding habits between hatchlings and adults. The bone tissue of some adult titanosaurs was rapidly and cyclically deposited and shows a greater degree of remodeling than in other sauropods. Saltasaurines in particular show evidence of postcranial skeletal pneumaticity in both axial and appendicular skeleton, providing clues about soft tissue anatomy and the structure of the respiratory system. Titanosaurs, like all sauropods, were characterized by being fully quadrupedal, although some appendicular features and putative trackways indicate that their stance was not as columnar as in other sauropods. These anatomical peculiarities are significantly developed In saltasaurines, a derived group of titanosaurs. Compared with other sauropods, some titanosaurs seem to have had very poor olfaction but would have been capable of capturing sounds In a relatively wide range of high frequencies, although not to the extent of living birds.El conocimiento paleobiológico de los saurópodos titanosaurios, particularmente su reproducción y biología del desarrollo, fue alcanzado recién en los últimos quince años. En estos últimos años también se ha avanzado en temas poco explorados hasta el momento, como la neumatización, su arquitectura muscular y locomoción y la reconstrucción de partes blandas como el cerebro y estructuras asociadas. Algunos titanosaurios depositan sus numerosos y pequeños huevos megaloolitidos en nidos excavados sobre el suelo. Durante la ontogenia ciertos titanosaurios exponen algunas variaciones en su morfología craneana, algunas de estas probablemente asociadas con las diferentes maneras de alimentarse que tendrían los juveniles y los adultos. El tejido óseo de algunos titanosaurios adultos se habría depositado rápido y cíclicamente, exponiendo una mayor remodelación que en otros saurópodos. Los titanosaurios, particularmente los saltasaurinos, exponen una neumaticidad postcraneal en el esqueleto axial y apendicular, este carácter permite Inferir la anatomía de sus tejidos blandos y de su sistema respiratorio. Los titanosaurios, como todos los saurópodos, estaban caracterizados por ser cuadrúpedos, aunque algunos caracteres apendiculares y las huellas indican que su postura no habría sido tan columnar como en otros saurópodos. Aquellas peculiaridades anatómicas están notoriamente desarrolladas en los saltasaurinos, un grupo de titanosaurios derivados. Comparado con otros saurópodos, algunos titanosaurios parecen haber tenido un pobre sentido del olfato, sin embargo estos habrían tenido la capacidad de captar sonidos de alta frecuencia en un rango relativamente amplio, aunque no tanto como las aves actuales.Fil: Garcia, Rodolfo Andres. Provincia de Río Negro. Museo Provincial “Carlos Ameghino”. Instituto de Investigación en Paleobiología y Geología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Salgado, Leonardo. Provincia de Río Negro. Instituto de Investigación en Paleobiología y Geología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Fernández, Mariela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Patagonia Norte. Instituto de Investigación en Biodiversidad y Medioambiente; Argentina. Universidad Nacional del Comahue. Centro Regional Universitario Bariloche; ArgentinaFil: Cerda, Ignacio Alejandro. Provincia de Río Negro. Museo Provincial “Carlos Ameghino”. Instituto de Investigación en Paleobiología y Geología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Paulina Carabajal, Ariana. Provincia del Neuquen. Municipalidad de Plaza Huincul. Museo "Carmen Funes"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Otero, Alejandro. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Departamento Científico de Paleontología de Vertebrados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Coria, Rodolfo Anibal. Universidad Nacional de Rio Negro. Sede Alto Valle. Instituto de Investigaciones en Paleobiologia y Geologia; Argentina. Provincia del Neuquen. Municipalidad de Plaza Huincul. Museo "Carmen Funes"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Fiorelli, Lucas Ernesto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Regional de Investigaciones Cientificas y Transferencia Tecnológica de Anillaco; Argentin