Factors Associated with Unplanned Conversion to Open in Nephrectomy for Kidney Cancer

Minimally invasive surgery (MIS) has been adopted as an approach in kidney surgery. Laparoscopic kidney surgery has been introduced in the 1990s with robotics emerging a decade after. The minimally invasive approach has been technically feasible and has been shown to be noninferior with preserved oncology standards to open surgery. The ubiquitous use of MIS for kidney cancer has been standard of practice; however, unplanned conversion to open kidney surgery has been characterized at 4.9% for laparoscopic radical nephrectomy compared to 6.0% in robotic radical nephrectomy. Another analysis of 54,246 patients undergoing partial nephrectomy for kidney cancer observed an unplanned open conversion rate of 2.87% for cT1 renal masses. Furthermore, the unplanned conversion to open radical or partial nephrectomy after an attempted minimally invasive approach has been an independent predictor of increased risk of 30-day hospital readmission. Currently, the relative risk factors to predict unplanned conversion to open surgery has not been well characterized. Greater understanding of risk factors for unplanned open conversion has clinical implications to reduce intraoperative and postoperative outcomes. The early recognition of nationwide risk and predictors may aid in identifying patients for planned open kidney surgery. We aim to use the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to identify predictors and outcomes in a contemporary cohort

Care Staff and the Creative Arts: Exploring the Context of Involving Care Personnel in Arts Interventions

Background: Arts-based interventions play an important role in the care of people with dementia. Yet, creative arts are seldom implemented as a tool to enhance the care and wellbeing of people with dementia. Methods: We examined the involvement of care staff in creative arts activities in residential care. Aspects of involvement that appear to influence outcomes in people with dementia were identified and analyzed. A broad systematic literature search of MedLine, EMBASE, PsychInfo, CINAHL, ASSIA, SCOPUS, and Web of Science led to the identification of 14 papers. The studies identified through the search process were examined in terms of intervention, context, mechanism and outcome, and the relationships between these aspects. Results: Training sessions were identified as an opportunity to educate care personnel on useful techniques that are relevant to daily care practice. Evidence from the literature suggests that creative arts programs play a significant role in the way staff and residents interact and as a result influence the care practice of staff. Under certain conditions creative arts programs, that involve and engage staff, facilitate enhanced interactions and improve care strategies, which leads to the recognition and validation of personhood in residents with dementia. Conclusions: These findings provide a basis for illustrating which elements of care staff involvement in creative arts programs could be implemented in residential care contexts in order to have the upmost benefit. Copyright © International Psychogeriatric Association 2017

Hyperprolactinemia-induced ovarian acyclicity is reversed by kisspeptin administration

Hyperprolactinemia is the most common cause of hypogonadotropic anovulation and is one of the leading causes of infertility in women aged 25-34. Hyperprolactinemia has been proposed to block ovulation through inhibition of GnRH release. Kisspeptin neurons, which express prolactin receptors, were recently identified as major regulators of GnRH neurons. To mimic the human pathology of anovulation, we continuously infused female mice with prolactin. Our studies demonstrated that hyperprolactinemia in mice induced anovulation, reduced GnRH and gonadotropin secretion, and diminished kisspeptin expression. Kisspeptin administration restored gonadotropin secretion and ovarian cyclicity, suggesting that kisspeptin neurons play a major role in hyperprolactinemic anovulation. Our studies indicate that administration of kisspeptin may serve as an alternative therapeutic approach to restore the fertility of hyperprolactinemic women who are resistant or intolerant to dopamine agonists

Applying a gender lens to biodiversity conservation in High Asia

Community-based conservation efforts represent an important approach to facilitate the coexistence of people and wildlife. A concern, however, is that these efforts build on existing community structures and social norms, which are commonly dominated by men. Some biodiversity conservation approaches may consequently neglect women’s voices and deepen existing inequalities and inequities. This paper presents two community case studies that draw upon the knowledge and experience gained in our snow leopard conservation practice in pastoral and agro-pastoral settings in Mongolia and India to better understand women’s roles and responsibilities. In these settings, roles and responsibilities in livestock management and agriculture are strongly differentiated along gender lines, and significant gaps remain in women’s decision-making power about natural resources at the community level. We argue that context-specific and gender-responsive approaches are needed to build community support for conservation actions and leverage women’s potential contributions to conservation outcomes.Peer Reviewe

The tyrosine kinase inhibitor sunitinib affects ovulation but not ovarian reserve in mouse: A preclinical study

The aim of the study was to evaluate ovarian toxicity of tyrosine kinase inhibitor (TKI) sunitinib, since only scarce data are available on gonadal function after this treatment. Six-weekold female mice received orally, once daily, vehicle or sunitinib (50 mg/kg/d) during 5 weeks. Fertility parameters were analyzed from ovulation to litter assessment. Sunitinib exposure significantly reduced (i) corpora lutea number per ovary (1.1 ± 0.38 in sunitinib group versus 4 ± 0.79 in control group, p<0.01) and (ii) serum Anti Müllerian hormone (AMH) levels in sunitinib treated mice (12.01 ± 1.16) compared to control mice (14.33 ± 0.87 ng/ml, p< 0.05). However, primordial and growing follicles numbers per ovary were not different in both groups. After treatment withdrawal, female mice in both groups were able to obtain litters. These data could be helpful to counsel clinicians and patients, when fertility preservation methods are discussed, before TKI treatment in girls and young women

Lone Wolves and Stray Dogs: The Japanese Crime Film, 1931-1969

“Lone Wolves and Stray Dogs: The Japanese Crime Film, 1931–1969” is a continuing collaboration between the Council on East Asian Studies at Yale University and the National Film Center of the National Museum of Modern Art, Tokyo. Ever since the success of the French crime film Zigomar in 1911, the Japanese film industry has produced numerous movies depicting criminals and the detectives who try to apprehend them. Chivalric yakuza, modern mobsters, knife-wielding molls, hardboiled gumshoes, samurai detectives, femme fatales, and private eyes populate Japanese cinema, from period films to contemporary dramas, from genre cinema to art film, from the work of genre auteurs like Makino Masahiro to masters like Kurosawa Akira. Cinematic representations of crime have served in Japan to draw the boundaries of society and the nation, define the nature of reason and epistemology, shape subjectivity and gender, explore the transformations of modernity, and even express the desire for political transformation. Surprisingly, little of this rich lode of cinema has been introduced abroad. The film series, which took place over a period of four weeks in January and February 2015, presented some of the masterworks of Japanese gangster film, detective cinema, and Japanese noir, in subtitled archive prints that have rarely been seen abroad. The series concluded with a symposium featuring an international panel of experts on Japanese crime film, and a world premiere screening of a newly struck English subtitled print of the classic gangster melodrama, Chutaro of Banba. All films were screened in 35mm with English subtitles. In conjunction with the series, the Council on East Asian Studies at Yale University printed a pamphlet that features introductions to each of the ten films shown, as well as critical overviews of the genre penned by and Yomota Inuhiko (Kyoto University of Art and Design), Ōsawa Jō (The National Film Center, Tokyo) and Phil Kaffen (New York University). The publication was produced by the graduate students in the Department of East Asian Languages and Literatures and the Film and Media Studies Program at Yale under the supervision of Professor Aaron Gerow (East Asian Languages and Literatures; Film and Media Studies), and provides a detailed and enlightening introduction to this important genre of Japanese cinema. The film series was also supported by the Yale Film Studies Center and Films at the Whitney

An applied ecology of fear framework: linking theory to conservation practice

Research on the ecology of fear has highlighted the importance of perceived risk from predators and humans in shaping animal behavior and physiology, with potential demographic and ecosystem-wide consequences. Despite recent conceptual advances and potential management implications of the ecology of fear, theory and conservation practices have rarely been linked. Many challenges in animal conservation may be alleviated by actively harnessing or compensating for risk perception and risk avoidance behavior in wild animal populations. Integration of the ecology of fear into conservation and management practice can contribute to the recovery of threatened populations, human–wildlife conflict mitigation, invasive species management, maintenance of sustainable harvest and species reintroduction plans. Here, we present an applied framework that links conservation interventions to desired outcomes by manipulating ecology of fear dynamics. We discuss how to reduce or amplify fear in wild animals by manipulating habitat structure, sensory stimuli, animal experience (previous exposure to risk) and food safety trade-offs to achieve management objectives. Changing the optimal decision-making of individuals in managed populations can then further conservation goals by shaping the spatiotemporal distribution of animals, changing predation rates and altering risk effects that scale up to demographic consequences. We also outline future directions for applied research on fear ecology that will better inform conservation practices. Our framework can help scientists and practitioners anticipate and mitigate unintended consequences of management decisions, and highlight new levers for multi-species conservation strategies that promote human–wildlife coexistence