Asymmetric thinning of the cerebral cortex across the adult lifespan is accelerated in Alzheimer’s disease

© 2021, The Author(s). Aging and Alzheimer’s disease (AD) are associated with progressive brain disorganization. Although structural asymmetry is an organizing feature of the cerebral cortex it is unknown whether continuous age- and AD-related cortical degradation alters cortical asymmetry. Here, in multiple longitudinal adult lifespan cohorts we show that higher-order cortical regions exhibiting pronounced asymmetry at age ~20 also show progressive asymmetry-loss across the adult lifespan. Hence, accelerated thinning of the (previously) thicker homotopic hemisphere is a feature of aging. This organizational principle showed high consistency across cohorts in the Lifebrain consortium, and both the topological patterns and temporal dynamics of asymmetry-loss were markedly similar across replicating samples. Asymmetry-change was further accelerated in AD. Results suggest a system-wide dedifferentiation of the adaptive asymmetric organization of heteromodal cortex in aging and AD

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Genetic parameters of legs defects, performance and carcass traits in broiler chickens

Os defeitos de pernas são decorrentes do rápido crescimento das aves, tornando-se necessário um estudo genético das associações entre essas características. Os objetivos deste estudo foram estimar os parâmetros genéticos para defeitos de pernas por escore visual, discondroplasia tibial, características de desempenho e carcaça, assim como estimar as tendências genéticas, ganho genético potencial e respostas correlacionadas, em uma linhagem de frangos de corte. O banco de dados utilizado neste estudo foi composto por registros de 128.459 aves, com informações de pedigree, manejo, desempenho, qualidades e defeitos de carcaça pertencentes a um rebanho elite de uma linhagem comercial de frangos de corte sob seleção. As características estudadas foram: os pesos vivos do animal aos sete (P7), 30 (P30) e 38 dias de idade (P38), peso ao abate (PA), peso eviscerado (PE), peso de peito (PPEI), peso de pernas (PPER), rendimento de carcaça (RCAR), rendimento de peito em relação ao peso ao abate (RPEI), rendimento de pernas em relação ao peso ao abate (RPER), eficiência alimentar (EFAL), defeito de pernas por escore visual (DPER), discondroplasia tibial (DT) e defeito de pernas total (DPERT). Para as características P7, P30, P38, PA, PE, PPEI, PPER, RCAR, RPEI, RPER, EFAL as análises genéticas foram realizadas pela metodologia dos modelos lineares clássicos, utilizando o método da Máxima Verossimilhança Restrita (REML) sob um modelo animal. Além da metodologia dos modelos lineares clássicos, as análises genéticas para as características DPER, DT e DPERT foram realizadas utilizando modelos lineares generalizados com função de ligação logit, devido à natureza categórica destas características, empregando-se modelo animal e modelo pai, com o método da quasi-verossimilhança penalizada (PQL). As análises foram obtidas utilizando-se o software ASREML®. As estimativas de herdabilidades obtidas para as características estudadas variaram de moderadas a altas, exceto para DT e DPERT, para as quais as estimativas de herdabilidades foram baixas. As estimativas de correlações genéticas entre as características de desempenho e carcaça e defeitos de pernas variaram de moderadas a altas, exceto para DPER e EFAL que apresentaram baixas correlações genéticas com as características de desempenho carcaça. As tendências genéticas para as características de desempenho e carcaça são indicativas que há seleção para características de peso vivo em diferentes idades e de desempenho e carcaça nesta linhagem, diferente do que acontece para as características de DPER, DT e DPERT, para as quais não há seleção evidente nessa linhagem.The legs defects are caused by rapid growth of broilers, therefore it is necessary to study of genetic associations between these traits. The objectives of this study were to estimate genetic parameters for legs defects by visual score, tibial dyschondroplasia, performance and carcass traits, and to estimate the genetic trends, potential genetic gain and correlated response in a broiler line. The database used in this study consisted of records from 128,459 birds, containing pedigree information, management, performance, qualities and defects, of an elite flock from a commercial strain of broiler chickens under selection. The traits studied were: the live weight at seven (P7), 30 (P30) and 38 days old (P38), slaughter weight (PA), carcass weight (PE), breast weight (PPEI), leg weight (PPER), carcass yield (RCAR), breast yield (RPEI), legs yield (RPER), feed efficiency (EFAL), legs defect by visual score (DPER), tibial dyschondroplasia (DT) and legs total defects (DPERT). For the traits P7, P30, P38, PA, PE, PPEI, PPER, RCAR, RPEI, RPER, EFAL statistics and genetic analysis done through classical linear models methodology, using the method of Restricted Maximum Likelihood (REML) under an animal model. Besides the classical linear model methodology, genetic analyzes for the traits DPER, DT and DPERT were done using generalized linear models with logit link, due to the categorical nature of these traits, using an animal and sire models, by the method of penalized quasilikelihood (PQL). Full analyzes were obtained using the ASREML® software. Estimates of heritability obtained for the traits varied from moderate to high, except for DT and DPERT, which heritability were low. Estimates of genetic correlations between performance and carcass traits and leg defects varied from moderate to high, except for DPER and EFAL, which presented low genetic correlations with performance characteristics of the carcass. Genetic trends for performance and carcass characteristics indicate that selection occurs for body weight at different ages and performance and carcass traits in this strain, in a different way to the observed for traits of DPER, DT and DPERT, which no evident selection in this line was observed