SARS‐CoV‐2 infection has produced high mortality in kidney transplant (KT) recipients, especially in the elderly. Until December 2020, 1011 KT with COVID‐19 have been prospectively included in the ...Spanish Registry and followed until recovery or death. In multivariable analysis, age, pneumonia, and KT performed ≤6 months before COVID‐19 were predictors of death, whereas gastrointestinal symptoms were protective. Survival analysis showed significant increasing mortality risk in four subgroups according to recipient age and time after KT (age <65 years and posttransplant time >6 months, age <65 and time ≤6, age ≥65 and time >6 and age ≥65 and time ≤6): mortality rates were, respectively, 11.3%, 24.5%, 35.4%, and 54.5% (p < .001). Patients were significantly younger, presented less pneumonia, and received less frequently specific anti‐COVID‐19 treatment in the second wave (July–December) than in the first one (March–June). Overall mortality was lower in the second wave (15.1 vs. 27.4%, p < .001) but similar in critical patients (66.7% vs. 58.1%, p = .29). The interaction between age and time post‐KT should be considered when selecting recipients for transplantation in the COVID‐19 pandemic. Advanced age and a recent KT should foster strict protective measures, including vaccination.
Older recipients diagnosed with COVID‐19 in the first 6 months after transplantation present the highest risk for a fatal outcome during the second wave of the COVID‐19 pandemic.
Local relapse and peritoneal carcinomatosis (PC) for pT4 colon cancer is estimated in 15,6% and 36,7% for 12 months and 36 months from surgical resection respectively, achieving a 5 years overall ...survival of 6%. There are promising results using prophylactic HIPEC in this group of patients, and it is estimated that up to 26% of all T4 colon cancer could benefit from this treatment with a minimal morbidity. Adjuvant HIPEC is effective to avoid the possibility of peritoneal seeding after surgical resection. Taking into account these results and the cumulative experience in HIPEC use, we will lead a randomized controlled trial to determine the effectiveness and safety of adjuvant treatment with HIPEC vs. standard treatment in patients with colon cancer at high risk of peritoneal recurrence (pT4).
The aim of this study is to determine the effectiveness and safety of adjuvant HIPEC in preventing the development of PC in patients with colon cancer with a high risk of peritoneal recurrence (cT4). This study will be carried out in 15 Spanish HIPEC centres. Eligible for inclusion are patients who underwent curative resection for cT4NxM0 stage colon cancer. After resection of the primary tumour, 200 patients will be randomized to adjuvant HIPEC followed by routine adjuvant systemic chemotherapy in the experimental arm, or to systemic chemotherapy only in the control arm. Adjuvant HIPEC will be performed simultaneously after the primary resection. Mitomycin C will be used as chemotherapeutic agent, for 60 min at 42-43 °C. Primary endpoint is loco-regional control (LC) in months and the rate of loco-regional control (%LC) at 12 months and 36 months after resection.
We assumed that adjuvant HIPEC will reduce the expected absolute risk of peritoneal recurrence from 36% to 18% at 36 months for T4 colon-rectal carcinoma.
NCT02614534 ( clinicaltrial.gov ) Nov-2015.
ABSTRACT
Carrion ecology, i.e. the decomposition and recycling of dead animals, has traditionally been neglected as a key process in ecosystem functioning. Similarly, despite the large threats that ...inland aquatic ecosystems (hereafter, aquatic ecosystems) face, the scientific literature is still largely biased towards terrestrial ecosystems. However, there has been an increasing number of studies on carrion ecology in aquatic ecosystems in the last two decades, highlighting their key role in nutrient recirculation and disease control. Thus, a global assessment of the ecological role of scavengers and carrion in aquatic ecosystems is timely. Here, we systematically reviewed scientific articles on carrion ecology in aquatic ecosystems to describe current knowledge, identify research gaps, and promote future studies that will deepen our understanding in this field. We found 206 relevant studies, which were highly biased towards North America, especially in lotic ecosystems, covering short time periods, and overlooking seasonality, a crucial factor in scavenging dynamics. Despite the low number of studies on scavenger assemblages, we recorded 55 orders of invertebrates from 179 families, with Diptera and Coleoptera being the most frequent orders. For vertebrates, we recorded 114 species from 40 families, with birds and mammals being the most common. Our results emphasise the significance of scavengers in stabilising food webs and facilitating nutrient cycling within aquatic ecosystems. Studies were strongly biased towards the assessment of the ecosystem effects of carrion, particularly of salmon carcasses in North America. The second most common research topic was the foraging ecology of vertebrates, which was mostly evaluated through sporadic observations of carrion in the diet. Articles assessing scavenger assemblages were scarce, and only a limited number of these studies evaluated carrion consumption patterns, which serve as a proxy for the role of scavengers in the ecosystem. The ecological functions performed by carrion and scavengers in aquatic ecosystems were diverse. The main ecological functions were carrion as food source and the role of scavengers in nutrient cycling, which appeared in 52.4% (N = 108) and 46.1% (N = 95) of publications, respectively. Ecosystem threats associated with carrion ecology were also identified, the most common being water eutrophication and carrion as source of pathogens (2.4%; N = 5 each). Regarding the effects of carrion on ecosystems, we found studies spanning all ecosystem components (N = 85), from soil or the water column to terrestrial vertebrates, with a particular focus on aquatic invertebrates and fish. Most of these articles found positive effects of carrion on ecosystems (e.g. higher species richness, abundance or fitness; 84.7%; N = 72), while a minority found negative effects, changes in community composition, or even no effects. Enhancing our understanding of scavengers and carrion in aquatic ecosystems is crucial to assessing their current and future roles amidst global change, mainly for water–land nutrient transport, due to changes in the amount and speed of nutrient movement, and for disease control and impact mitigation, due to the predicted increase in occurrence and magnitude of mortality events in aquatic ecosystems.
BACKGROUND: This study aims to implement a set of wearable technologies to record and analyze the surgeon’s physiological and ergonomic parameters during the performance of conventional and ...robotic-assisted laparoscopic surgery, comparing the ergonomics and stress levels of surgeons during surgical procedures. METHODS: This study was organized in two different settings: simulator tasks and experimental model surgical procedures. The participating surgeons performed the tasks and surgical procedures in both laparoscopic and robotic-assisted surgery in a randomized fashion. Different wearable technologies were used to record the surgeons’ posture, muscle activity, electrodermal activity and electrocardiography signal during the surgical practice. RESULTS: The simulator study involved six surgeons: three experienced (>100 laparoscopic procedures performed; 36.33 ± 13.65 years old) and three novices (<100 laparoscopic procedures; 29.33 ± 8.39 years old). Three surgeons of different surgical specialties with experience in laparoscopic surgery (>100 laparoscopic procedures performed; 37.00 ± 5.29 years old), but without experience in surgical robotics, participated in the experimental model study. The participating surgeons showed an increased level of stress during the robotic-assisted surgical procedures. Overall, improved surgeon posture was obtained during robotic-assisted surgery, with a reduction in localized muscle fatigue. CONCLUSIONS: A set of wearable technologies was implemented to measure and analyze surgeon physiological and ergonomic parameters. Robotic-assisted procedures showed better ergonomic outcomes for the surgeon compared to conventional laparoscopic surgery. Ergonomic analysis allows us to optimize surgeon performance and improve surgical training.
Highlights • Anti-CD20 mAbs combined with chemotherapy have become the standard treatment of Non-Hodgkin Lymphomas (NHL). • Mechanisms of action of this anti-CD20 mAbs in vivo are not fully ...understood. • Binding of rituximab to CD20 is not sufficient to heal every patient with a Non-Hodgkin Lymphoma. • We review the mechanisms of action and resistance of rituximab, and the efforts needed to overcome it. • We also focus on new drugs targeting pathways implicated in resistance to anti-CD20 mAbs.
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•Microcontaminants eliminated (>99%) by ozonation but acute toxicity increased.•Acute toxicity was related to microcontaminant byproducts or other water components.•D. magna ...adaptation and reduction of chronic toxicity in S. capricornutum was observed.•Ozonation and membrane technologies could be combined to treat microcontaminants.
The purpose of this work was to study the ozonation of nanofiltration (NF) retentates of real municipal wastewater treatment plant (MWTP) effluents for removal of microcontaminants (MCs) and toxicity. MCs present in these effluents were monitored using LC–MS/MS. Acute and chronic toxicity was addressed with Daphnia magna, Vibrio fischeri and Selenastrum capricornutum. Up to 40 MCs were found, most of them in concentrations over 100ng/L. 90% degradation of the sum of MCs was the critical point of comparison. When the NF membrane system was applied to MWTP effluents, treatment of NF rejection needed 2.75–4.5g O3/m3,4.5g O3/m3, which is less than 50% of the ozone needed for direct treatment of MWTP effluent. Treatment time (lower than 11min) was not influenced by MCs concentration, at least in the range tested (25–190μg/L). It has been demonstrated that consumption of ozone increased with organic load and inorganic content of different real effluents. MCs were eliminated by ozonation but acute toxicity (against V. fischeri and D. magna) increased. Chronic toxicity results were different and contrary in D. magna and S. capricornutum, due to the generation of new transformation products more toxic to D. magna than the parent contaminants. S. capricornutum inhibition percentage decreased in all cases after ozonation treatment. According to these results, before ozonation is implemented in MWTPs for the removal of MCs, the transformation products must first be examined and the treatment time or ozone doses should be extended to complete degradation if necessary.
Various different physical processes contribute to the star formation and stellar mass assembly histories of galaxies. One important approach to understanding the significance of these different ...processes on galaxy evolution is the study of the stellar population content of today's galaxies in a spatially resolved manner. The aim of this paper is to characterize in detail the radial structure of stellar population properties of galaxies in the nearby universe, based on a uniquely large galaxy sample, considering the quality and coverage of the data. The sample under study was drawn from the CALIFA survey and contains 300 galaxies observed with integral field spectroscopy. To study mean trends with overall galaxy properties, the individual radial profiles are stacked in seven bins of galaxy morphology (E, SO,Sa, Sb, Sbc, Sc, and Sd). The galaxies from the sample have decreasing-outward stellar extinction; all spirals show similar radial profiles, independent from the stellar mass, but redder than E and SO. Overall, we conclude that quenching processes act in manners that are independent of mass, while metallicity and galaxy structure are influenced by mass-dependent processes.
We present an improved version of FIT3D, a fitting tool for the analysis of the spectroscopic properties of the stellar populations and the ionized gas derived from moderate resolution spectra of ...galaxies. This tool was developed to analyze integral field spectroscopy data and it is the basis of P 3D, a pipeline used in the analysis of CALIFA, MaNGA, and SAMI data. We describe the philosophy and each step of the fitting procedure. We present an extensive set of simulations in order to estimate the precision and accuracy of the derived parameters for the stellar populations and the ionized gas. We report on the results of those simulations. Finally, we compare the results of the analysis using FIT3D with those provided by other widely used packages, and we find that the parameters derived by FIT3D are fully compatible with those derived using these other tools.
We measured the gas abundance profiles in a sample of 122 face-on spiral galaxies observed by the CALIFA survey and included all spaxels whose line emission was consistent with star formation. This ...type of analysis allowed us to improve the statistics with respect to previous studies, and to properly estimate the oxygen distribution across the entire disc to a distance of up to 3−4 disc effective radii (re). We confirm the results obtained from classical H ii region analysis. In addition to the general negative gradient, an outer flattening can be observed in the oxygen abundance radial profile. An inner drop is also found in some cases. There is a common abundance gradient between 0.5 and 2.0 re of αO / H = − 0.075 dex /re with a scatter of σ = 0.016 dex /re when normalising the distances to the disc effective radius. By performing a set of Kolmogorov-Smirnov tests, we determined that this slope is independent of other galaxy properties, such as morphology, absolute magnitude, and the presence or absence of bars. In particular, barred galaxies do not seem to display shallower gradients, as predicted by numerical simulations. Interestingly, we find that most of thegalaxies in the sample with reliable oxygen abundance values beyond ~2 effective radii (57 galaxies) present a flattening of the abundance gradient in these outer regions. This flattening is not associated with any morphological feature, which suggests that it is a common property of disc galaxies. Finally, we detect a drop or truncation of the abundance in the inner regions of 27 galaxies in the sample; this is only visible for the most massive galaxies.
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