Anastomotic leak in ovarian cancer cytoreduction surgery: a systematic review and meta-analysis

Introduction: Anastomotic leaks (AL) following ovarian cytoreduction surgery could be detrimental, leading to significant delays in commencing adjuvant chemotherapy, prolonged hospital stays and increased morbidity. The aim of this study was to investigate risk factors associated with anastomotic leaks after ovarian cytoreduction surgery. Material and methods: The MEDLINE (via PubMed), Cochrane Library, EMBASE and Scopus bibliographical databases were searched. Original clinical studies investigating risk factors for AL in ovarian cytoreduction surgery were included. Results: Eighteen studies with non-overlapping populations reporting on patients undergoing cytoreduction surgery for ovarian cancer (n = 4622, including 344 cases complicated by AL) were included in our analysis. Patients undergoing ovarian cytoreduction surgery complicated by AL had a significantly higher rate of 30-day mortality but no difference in 60-day mortality. Multiple bowel resections were associated with an increased risk of postoperative AL, while no association was observed with body mass index (BMI), American Society of Anesthesiologists (ASA) score, age, smoking, operative approach (primary versus interval cytoreductive, stapled versus hand-sewn anastomoses and formation of diverting stoma), neoadjuvant chemotherapy and use of hyperthermic intraperitoneal chemotherapy (HIPEC). Discussion: Multiple bowel resections were the only clinical risk factor associated with increased risk for AL after bowel surgery in the ovarian cancer population. The increased 30-day mortality rate in patients undergoing ovarian cytoreduction complicated by AL highlights the need to minimize the number of bowel resections in this population. Further studies are required to clarify any association between neoadjuvant chemotherapy and decreased AL rates

On the self-pinning character of synchro-Shockley dislocations in a Laves phase during strain rate cyclical compressions

Strain rate cyclical tests in compression, between 1350 and 1500 degrees C, have been employed to study the self-pinning character of thermally activated synchro-Shockley dislocations in the C15 Cr2Nb Laves phase. An average minimum effective (pinning) stress was calculated to be necessary for their propagation. The dislocation velocity cannot respond instantly to the strain rate changes and requires variations in the mobile dislocation density because the synchro-Shockleys can be pinned if the cooperating motion of their two Shockley components is hindered. (c) 2008 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved

On the commutability of homogenization and linearization in finite elasticity

We study non-convex elastic energy functionals associated to (spatially) periodic, frame indifferent energy densities with a single non-degenerate energy well at SO(n). Under the assumption that the energy density admits a quadratic Taylor expansion at identity, we prove that the Gamma-limits associated to homogenization and linearization commute. Moreover, we show that the homogenized energy density, which is determined by a multi-cell homogenization formula, has a quadratic Taylor expansion with a quadratic term that is given by the homogenization of the quadratic term associated to the linearization of the initial energy density

The mechanical properties and the deformation microstructures of the C15 Laves phase Cr2Nb at high temperatures

Compression tests between 1250 and 1550 degrees C and 10(-5) and 5 x 10(-3) s(-1) and transmission electron microscopy have been employed to investigate the high temperature mechanical properties and the deformation mechanisms of the C15 Cr2Nb Laves phase. The stress-peaks in the compression curves during yielding were explained using a mechanism similar to strain aging combined with a low initial density of mobile dislocations. The primary deformation mechanism is slip by extended dislocations with Burgers vector 1/2 <110 >, whereas twinning is more frequent at 10(-4) s(-1). Schmid factor analysis indicated that twinning is more probable in grains oriented so as to have two co-planar twinning systems with high and comparable resolved shear stresses. Twinning produced very anisotropic microstructures. This may be due to synchroshear: a self-pinning mechanism which requires co-operative motion of zonal dislocations. (c) 2006 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved

Medium-chain triglycerides may improve memory in non-demented older adults: a systematic review of randomized controlled trials

publishedVersio

Medium-chain triglycerides may improve memory in non-demented older adults: a systematic review of randomized controlled trials

Background: Ketosis has been exploited for its neuroprotective impact and treatment of neurological conditions via ketone production. Exogenous medium-chain triglyceride (MCT) supplementation may induce nutritional ketosis. The aim of this systematic review is to explore the effects of MCTs on memory function in older adults without cognitive impairment. Methods: A systematic literature search of PubMed, Cochrane Library, Scopus, and Web of Science was employed from inception until April 2022 for randomized controlled trials (RCTs) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, investigating the impact of MCT oils on components of memory. Risk of bias (RoB2) tool was utilized for quality assessment. Results: Six trials were included for qualitative synthesis, in which two studies examined the effect of MCTs through a ketogenic meal. MCT supplementation compared to controls was associated with improved indices of memory function in 4 out of 6 studies, particularly working memory. A meta-analysis was not employed due to the low number of studies, therefore, a true effect measure of MCT supplementation was not explored. Conclusions: MCT supplementation may enhance working memory in non-demented older adults. These effects may be more prominent in individuals with lower baseline scores, from short and long-term supplementation. Further studies are warranted to confirm these findings in terms of optimal dose and MCTs composition, which may protect from memory decline during aging

Light4Health eLearning Course: health research for interior lighting design. Re-thinking design approaches based on science

This paper presents the results of \u27Light4Health\u27 (L4H), a three-year EU Erasmus+ Strategic Partnership grant project (2019-2021), which investigated, systematized and taught health-related research on the impact of natural and artificial light on human health and well-being relevant to indoor lighting design. The objective was to re-think evidence-based lighting design approaches for residential, working/educational, and healthcare spaces, in order to develop a novel cross-disciplinary eLearning platform, that intersects lighting design and current peer-reviewed health research through a select combination of the most relevant research, methods, and tools. The content was developed through teaching workshops with international researchers, teachers, and students. Participating students were introduced to the application of relevant research and new metrics, in order to produce creative lighting design proposals. Students were able to inform lighting design approaches that support health and well-being without compromising creativity via the tools and methods developed through the health sciences. With this project, participants and consortium members have narrowed the gap that exists between research and the practice/application of lighting, by translating research from complex scientific jargon into various tools for designers to use. The knowledge gained, was consolidated into an open-access online curriculum for international lighting design students, educators and professionals via the free eLearning Moodle platform (https://course.light4health.net/)

Evaluation of acceptability, functionality, and validity of a passive image-based dietary intake assessment method in adults and children of Ghanaian and Kenyan origin living in London, UK

BACKGROUND: Accurate estimation of dietary intake is challenging. However, whilst some progress has been made in high-income countries, low- and middle-income countries (LMICs) remain behind, contributing to critical nutritional data gaps. This study aimed to validate an objective, passive image-based dietary intake assessment method against weighed food records in London, UK, for onward deployment to LMICs. METHODS: Wearable camera devices were used to capture food intake on eating occasions in 18 adults and 17 children of Ghanaian and Kenyan origin living in London. Participants were provided pre-weighed meals of Ghanaian and Kenyan cuisine and camera devices to automatically capture images of the eating occasions. Food images were assessed for portion size, energy, nutrient intake, and the relative validity of the method compared to the weighed food records. RESULTS: The Pearson and Intraclass correlation coefficients of estimates of intakes of food, energy, and 19 nutrients ranged from 0.60 to 0.95 and 0.67 to 0.90, respectively. Bland-Altman analysis showed good agreement between the image-based method and the weighed food record. Under-estimation of dietary intake by the image-based method ranged from 4 to 23%. CONCLUSIONS: Passive food image capture and analysis provides an objective assessment of dietary intake comparable to weighed food records

The impact of branched-chain amino acid supplementation on measures of glucose homeostasis in individuals with hepatic disorders: A systematic review of clinical studies.

BackgroundBranched chain amino acid (BCAA) supplementation may influence glucose metabolism in individuals with impaired glycemic profile. This systematic review investigated the effects of isolated BCAA supplementation on measures of glucose homeostasis in individuals with hepatic disorders.MethodsWe searched PubMed, Web of Science, Cochrane Library, and Scopus for published clinical trials that investigated the effects of isolated BCAA supplementation on measures of glucose homeostasis, including serum glucose and insulin, glycated hemoglobin (HbA1c) levels, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) scores.ResultsEleven trials met the inclusion criteria. Only one study revealed a decrease in serum glucose from BCAA supplementation compared to three studies that showed increases. Five studies demonstrated no significant changes in serum glucose, and two studies displayed no changes in HbA1c following BCAA supplementation. Serum levels of insulin were decreased in three studies, remained unchanged in one, whilst increased in the remaining three studies. BCAA supplementation reduced HOMA-IR scores in two studies, increased HOMA-IR scores in another two or resulted in no changes in two other studies.ConclusionsBCAA supplementation in isolation had no effect on overall glucose homeostasis in individuals with hepatic disorders, although some improvements on serum insulin levels and HOMA-IR scores were observed. Overall, there is little evidence to support the utilization of BCAA supplementation as a potential nutritional strategy for improving measures of glucose homeostasis in individuals with hepatic disorders. This article is protected by copyright. All rights reserved