1,721,534 research outputs found
Machine learning risk prediction of mortality for patients undergoing surgery with perioperative SARS-CoV-2: the COVIDSurg mortality score
Full text linkto support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. we found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg mortality score (https://covidsurgrisk.app). our data demonstrates that it is safe to restart a wide range of surgical services for selected patients
National variations in perioperative assessment and surgical management of Crohn's disease: a multicentre study
Full text linkAim Crohn's disease (CD) requires a multidisciplinary approach and surgery should be undertaken by dedicated colorectal surgeons with audited outcomes. We present a national, multicentre study, with the aim to collect benchmark data on key performance indicators in CD surgery, to highlight areas where standards of CD surgery excel and to facilitate targeted quality improvement where indicated. Methods All patients undergoing ileocaecal or redo ileocolic resection in the participating centres for primary and recurrent CD from June 2018 to May 2019 were included. The main objective was to collect national data on hospital volume and practice variations. Postoperative morbidity was the primary outcome. Laparoscopic surgery and stoma rate were the secondary outcomes. Results In all, 715 patients were included: 457 primary CD and 258 recurrent CD with a postoperative morbidity of 21.6% and 34.7%, respectively. Laparoscopy was used in 83.8% of primary CD compared to 31% of recurrent CD. Twenty-five hospitals participated and the total number of patients per hospital ranged from 2 to 169. Hospitals performing more than 10 primary CD procedures per year showed a higher adoption of laparoscopy and bowel sparing surgery. Conclusions There is significant heterogeneity in the number of CD surgeries performed per year nationally in Italy. Our data suggest that high-volume hospitals perform more complex procedures, with a higher adoption of bowel sparing surgery. The rate of laparoscopy in high-volume hospitals is higher for primary CD but not for recurrent CD compared with low-volume hospitals
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Full text linkbackground: healthcare cannot achieve net-zero carbon without addressing operating theatres. the aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.Methods: This study adopted a four-phase delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was coprioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low-middle-income countries.Results: In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of 'single-use' consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low-middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.Conclusion: This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high- and low-middle-income countries
Postoperative anaemia increases unplanned readmission: an international prospective cohort study of patients undergoing major abdominal surgery
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Oncogene expression is modulated by recombinant human interferon-beta in human breast-cancer cells
Full text linkThe effect of recombinant human interferon-beta on growth and oncoprotein expression was investigated in several human breast-cancer cell lines with different characteristics. All cell lines tested were sensitive to the antiproliferative action of the drug, regardless of their estrogen sensitivity. The maximal inhibition of cell proliferation was seen after 6 days of treatment. In estrogen-sensitive CG-5 and ZR-75-1 cells, but not in MDA-MB-453 estrogen-insensitive cells, a reduction in c-myc and c-erbB2 oncoproteins occurred after 48-72 hr and became more pronounced after 120-168 hr of treatment, suggesting that this down-regulation is not direct but is mediated by undefined molecular mechanisms. The time-course of the IFN-mediated decrease in oncoproteins seems to indicate that this event is not strictly related to the IFN-regulation of cell proliferation. The expression of c-erbB2 and c-myc was also analyzed, after recombinant human interferon-beta treatment, at the mRNA level in CG-5 cells. Surprisingly, no statistically significant variation of c-erbB2 or of c-myc mRNA was found either before or after 120-168 hr. Thus, we surmise that the observed reduction of oncoproteins may be due to post-transcriptional mechanisms
L'Impresa al femminile, dall'imprenditività all'empowerment per l’innovazione.
No full textL’impresa al femminile offre un’analisi rigorosa delle dinamiche che caratterizzano l’imprenditoria femminile italiana, esplorandone il contributo economico e sociale in un contesto di crescente attenzione globale verso la parità di genere. Le autrici esaminano il tema con uno sguardo approfondito, ma anche multidimensionale, che unisce teorie economiche, analisi delle politiche europee di supporto e storie di successo concrete, fornendo un quadro esaustivo e stimolante per studiosi, politici e imprenditori.
Il volume si distingue per la prospettiva interdisciplinare e critica, che supera i tradizionali confronti di genere e ne propone una visione integrata. Risponde, dunque, all’esigenza di promuovere la comprensione di un fenomeno in rapida evoluzione, offrendo spunti pratici e teorici per tutti gli stakeholder interessati a valorizzare l’inclusione nel settore economico. Attraverso l’analisi di casi virtuosi, il testo dimostra come l’imprenditoria femminile stia trasformando il concetto stesso di impresa, ponendo un forte accento sulla sostenibilità, sull’etica e sull’impatto sociale
The growth of malignant and nonmalignant human cells is modulated by a human placental extract
No full textBackground: In the present paper, malignant and nonmalignant human cells were compared in their response to a fraction (fraction D, FD) of a human placental extract.
Materials and methods: The activity of FD was tested on cell proliferation both in the absence and in the presence of 5%, 10% and 15% fetal bovine serum (FBS). For cells growing in monolayers, the medium was renewed with fresh medium containing FD 24 hours after plating and 3 days after the first exposure. In breast cancer cells only, it was also changed after 6 days. For leukemic cells, which grow in suspension, FD was added directly to the medium the day of the seeding and then after 3 and 6 days.
Results: In normal fibroblasts, when plated at a low density, a strong inhibitory effect on cell growth was seen with the highest FD dose. This effect was observed in the presence of 5% and 10% FBS, while it disappeared with 15% FBS. In endothelial cells, FD, in the presence of 5% or 10% FBS, produced a modest but constant inhibition of cell proliferation, which was evident after a short treatment and with almost every dose of FD. Breast cancer and leukemic cell lines, plated at a standard density, were markedly inhibited by FD, but this effect was reversed in serum-free conditions, at least in mammary cells. In leukemic cells, after an initial stimulatory effect, FD was not able to counterbalance the absence of serum.
Conclusions: Our data seem to suggest that in FD both stimulating and inhibitory growth-factors coexist, the activity of which are greatly influenced by the culture conditions used
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