COVID-19 and Its Impact on Upper Gastrointestinal (GI) Cancer Management

Coronavirus disease 2019 (COVID-19), caused by the novel, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, has left dramatic footprints on human health and economy. Cancer, whilst not an infective disease, is prevalent in epidemic proportions and cannot be pretermitted due to the impact of COVID-19. As we emanate from the second national lockdown in the UK with mixed feelings of hope and despair—due to vaccination and new COVID-19 variant, respectively—we reflect on the impact of the first wave on the provision on diagnosis and management of with upper gastrointestinal (UGI) cancers. This review provides a critical analysis of available literature on COVID-19 and its impact on cancer management in general and that of UGI cancers in particular

PTPN22 gene polymorphism in Takayasu's arteritis

Objective. Takayasu's arteritis (TA) is a chronic, rare granulomatous panarteritis of unknown aetiology involving mainly the aorta and its major branches. In this study, genetic susceptibility to TA has been investigated by screening the functional single nucleotide polymorphism (SNP) of PTPN22 gene encoding the lymphoid-specific protein tyrosine phosphatase. Methods. Totally, 181 patients with TA and 177 healthy controls are genotyped by PCR-RFLP method for the SNP rs2476601 (A/G) of PTPN22 gene. Polymorphic region was amplified by PCR and digested with Xcm I enzyme. Results. Detected frequencies of heterozygous genotype (AG) were 5.1% (9/177) in control group and 3.8% (7/181) in TA group (P = 0.61, odds ratio: 0.75, 95% CI: 0.3, 2.0). No association with angiographic type, vascular involvement or prognosis of TA was observed either. Conclusion. The distribution of PTPN22 polymorphism did not reveal any association with TA in Turkey. © The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved

REFLECTION OF THREE DIMENSIONAL PRINTERS ON CONTEMPORARY CERAMIC ART

Sanat, insanın zihnindeki imgeleri eller ve aletler yardımı ile yaratıcı ve özgün biçimde somutlaştırmasıdır. Zamanla gelişen teknolojilerle beraber kullanılan alet ve malzemeler değişmiş, farklı üretim şekilleri ortaya çıkmıştır. Bu üretim şekillerinden birisi de, bilgisayar destekli üç boyutlu modelleme ve üç boyutlu yazıcılar olmuştur. 1980’lerden sonra üç boyutlu yazıcıların modelleme aşamaları tasarım ve üretim tarihinde yerini almış ve sanata etkilerini hızlıca göstermiştir. Prototipler, bilgisayar programları yardımıyla sanal ortamında modellenmesinden sonra bir kalıp tekniği kullanmaya gerek duyulmaksızın çizimin üç boyutlu yazıcıya gönderilerek basılmasıyla gerçekleştirilmektedir. Üç boyutlu yazıcının temel çalışma prensibi plastik, metal, seramik çamuru gibi malzemelerin katmanlar halinde üst üste gelerek formu oluşturması şeklindedir. Hızlı şekilde prototip üretimine elverişli olması ve modellemenin zor olduğu nesneleri daha kısa sürede daha verimli şekilde üretmeyi sağlaması gibi avantajları bakımından gelecekte seri üretimde kullanılması kaçınılmaz gözükmektedir. Bu makalede, üç boyutlu yazıcıların temel çalışma prensiplerine değinilmekte; seramik alanındaki kullanım olanakları sorgulanmaya çalışılmakta ve gelecekte çağdaş seramik sanatına yapacağı etkiler değerlendirilmektedir.Art is embodied by the way of creative and original with the help of hands and tools of images in human mind._x000D_ The tools and materials, which is used with the developing technologies over the time, have changed and different_x000D_ forms of production have emerged. One of these production methods has been computer aided three-dimensional_x000D_ modeling and three-dimensional printers. After the 1980s, the modeling stages of three-dimensional printers,_x000D_ that are quickly showed their effects on art, took their place in the history of design and production. Prototypes_x000D_ are realized by sending it to the three-dimensional printer without need to use a mold technique after modeling_x000D_ in the virtual environment with the help of computer programs and printing the drawing. The basic working_x000D_ principle of the three-dimensional printer is that materials such as plastic, metal and ceramic mud are formed_x000D_ by overlapping in layers and form. It seems inevitable to be used in serial production in the future in terms of_x000D_ its advantages such as being suitable for rapid prototype production and providing more efficient production of_x000D_ objects that are difficult to model._x000D_ In this article, basic principles of three-dimensional printers are mentioned; The possibilities for use in the field_x000D_ of ceramics are tried to be questioned and the effects of contemporary ceramic art on the future are evaluated

The role of the emergency department in the management of acute heart failure: an international perspective on education and research

Emergency departments are a major entry point for the initial management of acute heart failure (AHF) patients throughout the world. The initial diagnosis, management and disposition - the decision to admit or discharge - of AHF patients in the emergency department has significant downstream implications. Misdiagnosis, under or overtreatment, or inappropriate admission may place patients at increased risk for adverse events, and add costs to the healthcare system. Despite the critical importance of initial management, data are sparse regarding the impact of early AHF treatment delivered in the emergency department compared to inpatient or chronic heart failure management. Unfortunately, outcomes remain poor, with nearly a third of patients dying or re-hospitalised within 3 months post-discharge. In the absence of robust research evidence, consensus is an important source of guidance for AHF care. Thus, we convened an international group of practising emergency physicians, cardiologists and advanced practice nurses with the following goals to improve outcomes for AHF patients who present to the emergency department or other acute care setting through: (a) a better understanding of the pathophysiology, presentation and management of the initial phase of AHF care; (b) improving initial management by addressing knowledge gaps between best practices and current practice through education and research; and (c) to establish a framework for future emergency department-based international education and research

The Effect of Seawater Conductivity on the Treatment of Leachate by Electrocoagulation

The effect of seawater (SW) conductivity on the treatment of domestic solid waste leachates (DSWL) and hazardous solid waste leachates (HSWL) by means of EC was investigated. Seawater, which is a strong electrolyte with a rich content of ions, has been fed together with the leachates to the reactors with Fe and Al electrodes. In the experiments, the treatment was performed by mixing leachate (DSWL and HSWL) with seawater in the proportions of 1:1 and 1:3. The efficiency of the process was determined by observing such parameters of suspended solids as phosphate, sulphate, color and turbidity. It was determined that the removal efficiencies related to the amount of seawater added, increase for all parameters except sulphate ions removal. Obtained data showed the best removal efficiency for Fe and Al electrodes ranging from 67 % to 100 % in the phosphate content, color and turbidity. For suspended solids and sulfate ions, the removal efficiencies vary in the range of 50–70 %. The results show that seawater added to the process accelerates the EC process due to increasing conductivity and the presence of other ions in its composition

Clinical picture and risk prediction of short-term mortality in cardiogenic shock

AIMS: The aim of this study was to investigate the clinical picture and outcome of cardiogenic shock and to develop a risk prediction score for short-term mortality. METHODS AND RESULTS: The CardShock study was a multicentre, prospective, observational study conducted between 2010 and 2012. Patients with either acute coronary syndrome (ACS) or non-ACS aetiologies were enrolled within 6 h from detection of cardiogenic shock defined as severe hypotension with clinical signs of hypoperfusion and/or serum lactate >2 mmol/L despite fluid resuscitation (n = 219, mean age 67, 74% men). Data on clinical presentation, management, and biochemical variables were compared between different aetiologies of shock. Systolic blood pressure was on average 78 mmHg (standard deviation 14 mmHg) and mean arterial pressure 57 (11) mmHg. The most common cause (81%) was ACS (68% ST-elevation myocardial infarction and 8% mechanical complications); 94% underwent coronary angiography, of which 89% PCI. Main non-ACS aetiologies were severe chronic heart failure and valvular causes. In-hospital mortality was 37% (n = 80). ACS aetiology, age, previous myocardial infarction, prior coronary artery bypass, confusion, low LVEF, and blood lactate levels were independently associated with increased mortality. The CardShock risk Score including these variables and estimated glomerular filtration rate predicted in-hospital mortality well (area under the curve 0.85). CONCLUSION: Although most commonly due to ACS, other causes account for one-fifth of cases with shock. ACS is independently associated with in-hospital mortality. The CardShock risk Score, consisting of seven common variables, easily stratifies risk of short-term mortality. It might facilitate early decision-making in intensive care or guide patient selection in clinical trials

Maternal childbirth experience and induction of labour in each mode of delivery: a retrospective seven-year cohort study of 95,051 parturients in Finland

Childbirth experience has been shown to depend on the mode of delivery. However, it is unclear how labour induction influences the childbirth experience in different modes of delivery. Thus, we assessed the childbirth experience among mothers with spontaneous and induced labours.Background Childbirth experience has been shown to depend on the mode of delivery. However, it is unclear how labour induction influences the childbirth experience in different modes of delivery. Thus, we assessed the childbirth experience among mothers with spontaneous and induced labours. Design A retrospective cohort study. Setting Childbirths in four delivery hospitals in Helsinki and Uusimaa District, Finland, in 2012-2018. Sample 95051 childbirths excluding elective caesarean sections. Methods Obstetric data combined to maternal childbirth experience measured by Visual Analogue Scale (VAS) was analysed with univariate linear modelling and group comparisons. The primiparas and multiparas were analysed separately throughout the study due to the different levels of VAS. Main outcome measures Maternal childbirth experience measured by VAS. Results The negative effect of labour induction on the childbirth experience was discovered in each mode of delivery. Operative deliveries were perceived more negatively when they were preceded by labour induction. The rate of poor childbirth experience (VASPeer reviewe

Prognostic impact of baseline and residual SYNTAX scores in cardiogenic shock

Objectives The aim was to assess the extent of coronary artery disease and revascularization using baseline SYNTAX Score (bSS) and residual SYNTAX Score (rSS) in patients with cardiogenic shock (CS) secondary to ST-segment elevation myocardial infarction (STEMI). The prognostic impact of SYNTAX Score (SS) was evaluated and assessed for additive value over clinical risk scores. Background bSS and rSS have been proven to be useful in risk stratification in stable coronary artery disease as well as in acute coronary syndromes, but they have not been studied in STEMI related CS. Methods Patients from a multinational prospective study of CS were analyzed. The study population was divided into tertiles according to bSS. The Cox regression and receiver operating characteristic (ROC) curves were used to assess the predictive power of SS. Results Of the 61 studied patients, 85% were male and the mean age was 67 years. Median bSS was 22 (15-32) and rSS 7 (0-13). Ninety-day mortality was 43%. bSS had negative prognostic value in multivariable analysis (HR 1.06, 95% CI 1.01-1.10). However, additive value over clinical risk scores was limited. rSS was not associated with mortality, whereas post-percutaneous coronary intervention (PCI) TIMI flow 3 of infarct-related artery (IRA) predicted better survival. Conclusions In STEMI related CS, the added value of bSS and rSS over clinical assessment and risk scores is limited. Our results suggest that while immediate PCI in order to restore blood flow to the IRA is essential, deferring the treatment of residual lesions does not seem to be associated with worse prognosis.Peer reviewe

Complement Factor D Is a Novel Biomarker and Putative Therapeutic Target in Cutaneous Squamous Cell Carcinoma

Cutaneous squamous cell carcinoma (cSCC) is the most prevalent metastatic skin cancer. Previous studies have demonstrated the autocrine role of complement components in cSCC progression. We have investigated factor D (FD), the key enzyme of the alternative complement pathway, in the development of cSCC. RT-qPCR analysis of cSCC cell lines and normal human epidermal keratinocytes (NHEKs) demonstrated significant up-regulation of FD mRNA in cSCC cells compared to NHEKs. Western blot analysis also showed more abundant FD production by cSCC cell lines. Significantly higher FD mRNA levels were noted in cSCC tumors than in normal skin. Strong tumor cell-associated FD immunolabeling was detected in the invasive margin of human cSCC xenografts. More intense tumor cell-specific immunostaining for FD was seen in the tumor edge in primary and metastatic cSCCs, in metastases, and in recessive dystrophic epidermolysis bullosa-associated cSCCs, compared with cSCC in situ, actinic keratosis and normal skin. FD production by cSCC cells was dependent on p38 mitogen-activated protein kinase activity, and it was induced by interferon-γ and interleukin-1β. Blocking FD activity by Danicopan inhibited activation of extracellular signal-regulated kinase 1/2 and attenuated proliferation of cSCC cells. These results identify FD as a novel putative biomarker and therapeutic target for cSCC progression