A right hemicolectomy is among the most commonly performed operations for colon cancer, but modern high-quality, multination data addressing the morbidity and mortality rates are lacking.
This study ...reports the morbidity and mortality rates for right-sided colon cancer and identifies predictors for unfavorable short-term outcome after right hemicolectomy.
This was a snapshot observational prospective study.
The study was conducted as a multicenter international study.
The 2015 European Society of Coloproctology snapshot study was a prospective multicenter international series that included all patients undergoing elective or emergency right hemicolectomy or ileocecal resection over a 2-month period in early 2015. This is a subanalysis of the colon cancer cohort of patients.
Predictors for anastomotic leak and 30-day postoperative morbidity and mortality were assessed using multivariable mixed-effect logistic regression models after variables selection with the Lasso method.
Of the 2515 included patients, an anastomosis was performed in 97.2% (n = 2444), handsewn in 38.5% (n = 940) and stapled in 61.5% (n = 1504) cases. The overall anastomotic leak rate was 7.4% (180/2444), 30-day morbidity was 38.0% (n = 956), and mortality was 2.6% (n = 66). Patients with anastomotic leak had a significantly increased mortality rate (10.6% vs 1.6% no-leak patients; p > 0.001). At multivariable analysis the following variables were associated with anastomotic leak: longer duration of surgery (OR = 1.007 per min; p = 0.0037), open approach (OR = 1.9; p = 0.0037), and stapled anastomosis (OR = 1.5; p = 0.041).
This is an observational study, and therefore selection bias could be present. For this reason, a multivariable logistic regression model was performed, trying to correct possible confounding factors.
Anastomotic leak after oncologic right hemicolectomy is a frequent complication, and it is associated with increased mortality. The key contributing surgical factors for anastomotic leak were anastomotic technique, surgical approach, and duration of surgery. See Video Abstract at http://links.lww.com/DCR/B165. PREDICTORES DE FUGA ANASTOMóTICA, COMPLICACIONES POSTOPERATORIAS Y MORTALIDAD DESPUéS DE LA COLECTOMíA DERECHA POR CáNCER: RESULTADOS DE UNA AUDITORíA INTERNACIONAL DE CORTO PLAZO: La hemicolectomía derecha se encuentra entre las operaciones más frecuentemente realizadas para cáncer de colon, pero faltan datos modernos multinacionales de alta calidad, que aborden las tasas de morbilidad y mortalidad.Reportar la tasa de morbilidad y mortalidad para cáncer de colon del lado derecho, e identificar predictores de resultados desfavorables a corto plazo, después de la hemicolectomía derecha.Estudio prospectivo observacional de corto plazo.Estudio multicéntrico internacional.El estudio de corto plazo de la Sociedad Europea de Coloproctología de 2015, fue una serie prospectiva multicéntrica internacional, que incluyó a todos los pacientes sometidos a hemicolectomía derecha electiva, de emergencia o resección ileocecal, por un período de dos meses y a principios de 2015. Este es un subanálisis, cohorte de pacientes con cáncer de colon.Los predictores de fuga anastomótica, morbilidad y mortalidad postoperatorias a los 30 días, se evaluaron usando modelos de regresión logística de efectos multivariables mixtos, después de la selección de variables con el método Lasso.De los 2,515 pacientes incluidos, se realizó una anastomosis en el 97,2% (n = 2,444); sutura manual en 38.5% (n = 940) y por engrapadora en 61.5% (n = 1504) casos. La tasa global de fuga anastomótica fue del 7,4% (180/2,444), morbilidad a los 30 días fue del 38,0% (n = 956) y la mortalidad fue del 2,6% (n = 66). Los pacientes con fuga anastomótica tuvieron una tasa de mortalidad significativamente mayor (10,6% frente al 1,6% de pacientes sin fuga, p> 0,001). En el análisis multivariable, las siguientes variables se asociaron con la fuga anastomótica: mayor duración de la cirugía (OR 1.007 por minuto, p = 0.0037), abordaje abierto (OR 1.9, p = 0.0037) y anastomosis por engrapadora (OR 1.5, p = 0.041).Este es un estudio observacional y por lo tanto podría estar presente el sesgo de selección. Por esta razón, se realizó un modelo de regresión logística multivariable, tratando de corregir posibles factores de confusión.La fuga anastomótica después de la hemicolectomía derecha oncológica, es una complicación frecuente y asociada a mayor mortalidad. Los factores quirúrgicos clave que contribuyeron a la fuga anastomótica, fueron la técnica anastomótica, abordaje quirúrgico y duración de la cirugía. Consulte Video Resumen en http://links.lww.com/DCR/B165. (Traducción-Dr. Fidel Ruiz Healy).
Despite the importance of high-latitude surface energy budgets (SEBs) for land-climate interactions in the rapidly changing Arctic, uncertainties in their prediction persist. Here, we harmonize SEB ...observations across a network of vegetated and glaciated sites at circumpolar scale (1994-2021). Our variance-partitioning analysis identifies vegetation type as an important predictor for SEB-components during Arctic summer (June-August), compared to other SEB-drivers including climate, latitude and permafrost characteristics. Differences among vegetation types can be of similar magnitude as between vegetation and glacier surfaces and are especially high for summer sensible and latent heat fluxes. The timing of SEB-flux summer-regimes (when daily mean values exceed 0 Wm
) relative to snow-free and -onset dates varies substantially depending on vegetation type, implying vegetation controls on snow-cover and SEB-flux seasonality. Our results indicate complex shifts in surface energy fluxes with land-cover transitions and a lengthening summer season, and highlight the potential for improving future Earth system models via a refined representation of Arctic vegetation types.
Regenerating forests occupy large areas in the tropics, mostly as a result of deforestation for livestock and agriculture, followed by land abandonment. Despite the importance of regenerating ...secondary forests for tropical biodiversity conservation, studies of temporal effects of matrix regeneration on species responses in fragmented landscapes are scarce. Here, we used an Amazonian whole-ecosystem fragmentation experiment to investigate how changes in matrix quality over time through secondary forest regeneration affect bat assemblages from a functional perspective. We found that forest regeneration in the matrix positively affected functional α diversity, as well as species- and community-level functional uniqueness, reflecting an increase of species that perform different ecological functions in secondary forest over time. According to functional trait composition, animalivorous species showed the clearest signs of recovery associated with matrix regeneration. Consequently, between-period differences in functional β-diversity were highest in secondary forest compared to fragments and continuous forest, determined mainly by trait gains. However, ~30years of secondary forest regeneration were not sufficient for the functional recovery of bat assemblages to levels observed in continuous forest. Restoring degraded habitats while protecting primary forest will be an important strategy for safeguarding high functional diversity of bats and their vital contributions to ecosystem functioning in fragmented tropical landscapes.
•Temporal landscape dynamics affect several facets of bat functional diversity.•Bat functional trait responses are mediated by matrix regeneration over time.•Fragmentation-sensitive bat species benefit from matrix regeneration.
The synthesis and characterization of the complexes PdX(PPh3)(4-MeT)X (4-MeT=4-methyl-3-thiosemicarbazide; PPh3=triphenylphosphine; X=Cl, Br, I, SCN) have been described. The complexes were evaluated ...for in vitro activity as cytotoxic agents on tumor cells and also as cathepsin B and topoisomerase I and II inhibitors. Display omitted
•Cationic palladium compounds were prepared bearing thiosemicarbazide and triphenylphosphine.•The compounds were more cytotoxic than cisplatin against LM3 and MCF-7 tumor cells.•The complexes interact with topoisomerase II more efficiently than etoposide.•Cathepsin B activity is inhibited by Pd(II) compounds.
Sugarcane is an increasingly economically and environmentally important C4 grass, used for the production of sugar and bioethanol, a low-carbon emission fuel. Sugarcane originated from crosses of ...Saccharum species and is noted for its unique capacity to accumulate high amounts of sucrose in its stems. Environmental stresses limit enormously sugarcane productivity worldwide. To investigate transcriptome changes in response to environmental inputs that alter yield we used cDNA microarrays to profile expression of 1,545 genes in plants submitted to drought, phosphate starvation, herbivory and N2-fixing endophytic bacteria. We also investigated the response to phytohormones (abscisic acid and methyl jasmonate). The arrayed elements correspond mostly to genes involved in signal transduction, hormone biosynthesis, transcription factors, novel genes and genes corresponding to unknown proteins.
Adopting an outliers searching method 179 genes with strikingly different expression levels were identified as differentially expressed in at least one of the treatments analysed. Self Organizing Maps were used to cluster the expression profiles of 695 genes that showed a highly correlated expression pattern among replicates. The expression data for 22 genes was evaluated for 36 experimental data points by quantitative RT-PCR indicating a validation rate of 80.5% using three biological experimental replicates. The SUCAST Database was created that provides public access to the data described in this work, linked to tissue expression profiling and the SUCAST gene category and sequence analysis. The SUCAST database also includes a categorization of the sugarcane kinome based on a phylogenetic grouping that included 182 undefined kinases.
An extensive study on the sugarcane transcriptome was performed. Sugarcane genes responsive to phytohormones and to challenges sugarcane commonly deals with in the field were identified. Additionally, the protein kinases were annotated based on a phylogenetic approach. The experimental design and statistical analysis applied proved robust to unravel genes associated with a diverse array of conditions attributing novel functions to previously unknown or undefined genes. The data consolidated in the SUCAST database resource can guide further studies and be useful for the development of improved sugarcane varieties.
•We report INICC device-associated module data of 45 countries from 2012-2015.•We collected prospective data from 532,483 patients in 523 ICUs for 2,197,304 days.•DA-HAI rates and bacterial ...resistance were higher in INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's.
We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific.
During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care–associated infection (DA-HAI) were applied.
Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher.
Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.
A cryogen-free 6.6 T Superconducting Wavelength Shifter (SWLS) is currently being designed to produce photons with a critical energy higher than 39 keV for the future hard X-ray beamline of Sirius, a ...new 4th generation Brazilian light source. The magnet is based on NbTi coils and holmium poles with an operating margin above 20% at 5 K. A magnetic gap of 7 mm in the central pole was required to achieve a narrow peak field profile (FWHM = 29.8 mm), which did not affect the emittance of the machine. The device is designed to reuse several parts and equipment from a deactivated Superconducting Wiggler. The preliminary design of the SWLS is presented, focusing on electromagnetic, mechanical, thermal, and quench protection proposals.
The purpose of our work was to select phages displaying peptides capable of binding to vascular markers present in human atheroma, and validate their capacity to target the vascular markers in vitro ...and in low-density lipoprotein receptor knockout (LDLr(-/-)) mouse model of atherosclerosis. By peptide fingerprinting on human atherosclerotic tissues, we selected and isolated four different peptides sequences, which bind to atherosclerotic lesions and share significant similarity to known human proteins with prominent roles in atherosclerosis. The CTHRSSVVC-phage peptide displayed the strongest reactivity with human carotid atherosclerotic lesions (p < 0.05), when compared to tissues from normal carotid arteries. This peptide sequence shares similarity to a sequence present in the fifth scavenger receptor cysteine-rich (SRCR) domain of CD163, which appeared to bind to CD163, and subsequently, was internalized by macrophages. Moreover, the CTHRSSVVC-phage targets atherosclerotic lesions of a low-density lipoprotein receptor knockout (LDLr(-/-)) mouse model of atherosclerosis in vivo to High-Fat diet group versus Control group. Tetraazacyclododecane-1,4,7,10-tetraacetic acid-CTHRSSVVC peptide (DOTA-CTHRSSVVC) was synthesized and labeled with (111)InCl₃ in >95% yield as determined by high performance liquid chromatography (HPLC), to validate the binding of the peptide in atherosclerotic plaque specimens. The results supported our hypothesis that CTHRSSVVC peptide has a remarkable sequence for the development of theranostics approaches in the treatment of atherosclerosis and other diseases.
In this work we report a numerical Monte Carlo study of the behavior of a magnetic nano-disk put over an antiferromagnetic substrate. Three approaches were considered for describe the substrate: (1) ...A stacked antiferromagnetic configuration, (2) an Ising like arrangement and (3) Heisenberg like spins. For the Heisenberg case we still have considered an easy-plane and an easy-axis symmetry of the substrate. The hysteresis loop for the nano-disk is obtained by considering the three cases. The signature of the vortex in the nano-disk appears as small jumps in the hysteresis curve. Exchange bias effects are observed since the substrate has an easy axis symmetry.
► We study the behavior of the magnetic nano-disk put over an AFM substrate. ► We used three approach for the substrate: frozen, Ising and Heisenberg like spins. ► Exchange bias effects are observed since the substrate has an easy axis symmetry.
A Superconducting Wavelength Shifter (SWLS) capable of achieving a peak magnetic field of 6.6 T is currently being designed for a future hard X-ray beamline of Sirius, the new Brazilian Light Source. ...Due to the machine requirements, a narrow field profile in the central pole region (FWHM < 30 mm) is a constraint to the electromagnetic design. The superconducting racetrack coils, made of NbTi wires, are being designed to be conduction cooled with an operating margin above 20% at 5 K. Two designs are required, the lateral coils with 180 turns and the central coils with 1080 turns, both wound layer by layer with fiberglass insulation and then vacuum impregnated with epoxy resin. The proposed coils design and fabrication route will be presented, as well as the proposed setup for testing them.
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