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ABSTRACTThe UN’s Zero Tolerance Policy, which bans all relationships between UN staff and locals, portrays all relationships as exploitative, fails to account for nuances in these relationships and does not acknowledge the agency of local women or communities. This study uses community-based qualitative data from eastern DRC that shares narratives on a wide variety of consensual relationships between peacekeepers and local women. Our paper uses a data-driven approach, including a post-colonial feminist lens, and ideas of structural agency to provide an expanded definition of agency that invites readers to re-examine their views of women in conflict settings. Finally, we provide clear recommendations for the UN and other international non-governmental agencies on policies related to sexual exploitation and abuse.

Objective We aimed to determine the association of statins with progression to a high risk for advanced fibrosis in primary care patients with metabolic dysfunction-associated steatotic liver disease (MASLD).Design This retrospective cohort study of electronic health record data included patients with MASLD and an initial low or indeterminate risk for advanced fibrosis, determined by Fibrosis-4 Index (FIB-4) score (

Background: The management of locally advanced rectal cancer (LARC) relies on a multimodal approach. Neither instrumental work-up nor molecular biomarkers are currently available to identify a risk-adapted strategy. Objectives: We aim to investigate the role of circulating tumor DNA (ctDNA) and its clearance at different timepoints during chemo-radiotherapy (CRT) and correlate them with clinical outcomes. Design: Between November 2014 and November 2019, we conducted a monocentric prospective observational study enrolling consecutive patients with LARC managed with neoadjuvant standard CRT (capecitabine and concomitant pelvic long-course radiotherapy), followed by consolidation capecitabine in selected cases and surgery. Methods: Blood samples for ctDNA were obtained at pre-planned timepoints. We evaluated the correlation of baseline variant allele frequency (VAF) with pathologic complete response (pCR) down-staging, node regression (pN0), event-free survival (EFS), and overall survival (OS). Results: Among 112 screened patients, 61 were enrolled. In all, 38 (62%) had a positive ctDNA at baseline with VAF > 0 and 23 had negative ctDNA (VAF = 0). Among patients with negative ctDNA, 30% had a complete response, while only 13% of positive ctDNA patients had pCR [odds ratio (OR) 0.35 (95% confidence interval (CI): 0.10–1.26), p = 0.11]. Similarly, 96% and 74% of pN0 were observed among negative and positive ctDNA patients, respectively [OR 0.13 (95% CI: 0.02–1.07), p = 0.058]. The presence of a baseline VAF > 0 was associated with a trend toward a lower EFS compared with VAF = 0 patients [hazard ratio (HR) = 2.30, 95% CI: 0.63–8.36, p = 0.21]. Within the limitations of small sample size, no difference in OS was observed according to the baseline ctDNA status (HR = 1.18, 95% CI: 0.35–4.06, p = 0.79). Conclusion: Within the limitations of a reduced number of patients, patients with baseline negative ctDNA seem to show a higher probability of pN0 status and a trend toward improved EFS. Prospective translational studies are required to define the role of ctDNA analysis in the multimodal treatment of LARC.

This study evaluated the significance and predictive value of ultrasonographic and physical examination on arrival at an Austrian fattening farm. Treatment frequency and average daily weight gain (ADG) were related to physical and ultrasonographic examination results. Additionally, the effect of an intranasal vaccination in half of the examined calves was studied. The clinical and ultrasonographic health status 600 calves was recorded at the beginning and end of fattening. Half of the calves received an intranasal vaccination (Bovalto® Respi Intranasal). Overall, 44.5% showed an abnormal respiratory scoring (RS) and 56.0% showed signs of respiratory diseases in transthoracic ultrasonography (TUS) at arrival on the farm. For both RS and TUS, a categorization between ILL and HEALTHY was conducted. Results showed lower ADG in ILL calves (RS median: 0.93 kg/d; TUS median: 0.96 kg/d) compared to HEALTHY calves (RS median: 1.01 kg/d; TUS median: 1.01 kg/d). The median ADG was lower in not treated and ILL calves (RS median 0.90 kg/d; TUS: 0.93 kg/d) compared to treated and ILL calves (RS median 1.01 kg/d; TUS: 1.02 kg/d). Vaccination did not affect growth performance or occurrence of ILL, though treatment frequency was lower in VAC calves (17.0% in NVAC; 11.3% in VAC). The implementation of examination protocols for respiratory diseases may have a positive impact on production parameters (e.g., treatment frequency and ADG).

Abstract Background Chewing is an essential physiological process in horses; yet, the physical form of feeds may affect their chewing and feeding behaviour with consequences for equine digestion and health. Objectives and methods The present study evaluated the potential of a commercial forage cubes made from alfalfa and mixed meadow grasses to maintain chewing activity when compared with a traditional long and fibre‐rich hay. An additional aim was to measure the dust formation during feeding. The experiment was a crossover design with six horses (11 ± 4 years old, mean ± SD), fed with 5 kg (as‐fed basis) of their feed (long hay or alfalfa cubes) overnight. Eating and chewing activity was measured using the EquiWatch system with a sensor‐based halter. Results Data showed that by feeding the same amount of feed overnight, cube feeding led to 24% shorter eating time (on average 67 min less) and 26% fewer total chews compared to the long hay. On an hourly basis, horses also spent more time eating and chewing the long hay compared to the cubes. The cube feeding led to a higher dust concentration of the inhalable fraction (

Abstract Background The association between microbes and cancer has been reported repeatedly; however, it is not clear if molecular tumour properties are connected to specific microbial colonisation patterns. This is due mainly to the current technical and analytical strategy limitations to characterise tumour-associated bacteria. Methods Here, we propose an approach to detect bacterial signals in human RNA sequencing data and associate them with the clinical and molecular properties of the tumours. The method was tested on public datasets from The Cancer Genome Atlas, and its accuracy was assessed on a new cohort of colorectal cancer patients. Results Our analysis shows that intratumoural microbiome composition is correlated with survival, anatomic location, microsatellite instability, consensus molecular subtype and immune cell infiltration in colon tumours. In particular, we find Faecalibacterium prausnitzii, Coprococcus comes, Bacteroides spp., Fusobacterium spp. and Clostridium spp. to be strongly associated with tumour properties. Conclusions We implemented an approach to concurrently analyse clinical and molecular properties of the tumour as well as the composition of the associated microbiome. Our results may improve patient stratification and pave the path for mechanistic studies on microbiota-tumour crosstalk.

The history of intellectuals consists of a long-spanning entangled web of influences, interdependencies, and inspirations. In this paper, we construe the history of intellectuals by means of a formalized network approach, and structurally analyze how communities form and develop based on their intellectual influences. We are working with a unique data set of Linked Open Data, which we critically reflect upon. In this paper we tackle the question of whether community detection can help us to identify schools of thought, as well as patterns in the influence relations of scholars. We provide a detailed description of the process of extracting Linked Open Data, the construction of longitudinal networks, and the methodology of identifying and evaluating intellectual communities in the dataset using a community detection algorithm. Finally, we track the dynamic evolution of these communities over time, and characterize the structural patterns of their evolution, and the mechanisms of their development. We contextualize the changes in selected network structures in order to establish the merit of this method for a new perspective on the history of intellectuals, their influences, and their ideas.

The tumor immune microenvironment is an important prognostic determinant in colorectal cancer (CRC). Here the authors show that tumor infiltrating neutrophils expressing high levels of CD15 interact with CD8+ T effector memory skewing them to produce GZMK, associated with tumor progression in CRC patients.

Structural and spatial aspects of cell degradation are studied using a combination of diffraction-and imaging-based tools applying laboratory X-rays, neutron scattering and synchrotron radiation with electrochemical and thermal characterization. Experimental characterization is carried out on cylindrical cells of 21700-type, where four regimes of cell degradation are identified, which are supplemented by an increased cell resistance and surface temperature during cell operation. The amount of intercalated lithium in the fully charged anodes in the fresh and aged states is determined by ex situ X-ray diffraction radiography and in situ X-ray diffraction computed tomography. The qualitatively similar character of the results revealed a loss of active lithium along with the development of a complex heterogeneous distribution over the electrode stripe.

NomadTown a resilience hub based on learning for emergency prevention, positive impact creation, and adaptation is presented. The educative background of the sub-culture found there are outlined. A thick description of the educational milieu NomadTown is situated in is given. A contextualization of this milieu is provided with a Foucauldian awareness of the dispositif (apparatus). Whether the social ecology of associations, this resilience hub is becoming embedded in, is a suitable way to make the great transition needed to deal with climate change; and how organizational learning, manifesting as network learning, is taking place are considered. Such functioning connections are embodying the networked village concept of Nahrada’s Global Village Hypothesis. I conclude that working through connected networks, in NomadTown’s educational milieu, is an effective way to make change for resilience in our human survival situation when faced with climate change. However, NomadTown needs better connections to industry and government.

Introduction: Cranial remolding orthoses (CROs) are used to treat deformational plagiocephaly. Treatment outcomes vary widely depending on treatment timing and severity of the deformity. The relative impact of these factors on success rates is not well known. Objective: This study aimed to quantify success rates of CRO treatment, based on age at initiation of treatment and the severity of cranial deformity. Study Design: This is a retrospective cohort study of infants treated for positional plagiocephaly with a CRO. Methods: A total of 300 infants with deformational plagiocephaly who were treated with a CRO were categorized into four groups by corrected age at initiation of orthotic treatment (<22 weeks, 22–25 weeks, 26–30 weeks, and >30 weeks) and into four groups by severity of their deformity (initial cranial vault asymmetry of 6–9 mm, 10–12 mm, 13–16 mm, and 17+ mm). Success rates were compared across the groups. A successful outcome was defined as achieving a final cranial vault asymmetry of 5 mm or less. Results: The overall success rate for CRO treatment was 75%. However, success rates among the groups varied from 6% to 98%, depending on the severity and the age at initiation. Severity had a more significant effect on success rates than age at initiation. The age at initiation became more influential in determining the likelihood of success when the infant's deformity was severe. Conclusions: The likelihood of achieving a successful treatment outcome with a CRO varies greatly depending on the severity of the deformity and corrected age at initiation of treatment, with severity having the greater impact. Clinical Relevance: This study provides clinicians with treatment outcomes categorized by severity and corrected age at initiation to aid in setting appropriate expectations for treatment outcomes. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion ShuttlePump is a novel total artificial heart (TAH) recently introduced to potentially overcome the limitations associated with the current state‐of‐the‐art mechanical circulatory support devices intended for adults. In this study, we adapted the outflow cannulation of the previously established ShuttlePump TAH and evaluated the anatomical compatibility using the virtual implantation technique.We retrospectively assessed the anatomical compatibility of the ShuttlePump using virtual implantation techniques within 3D‐reconstructed anatomies of adult heart failure patients. Additionally, we examined the impact of outflow cannula modification on the hemocompatibility of the ShuttlePump through computational fluid dynamic simulations.A successful virtual implantation in 9/11 patients was achieved. However, in 2 patients, pump interaction with the thoracic cage was observed and considered unsuccessful virtual implantation. A strong correlation (r <−0.78) observed between the measured anatomical parameters and the ShuttlePump volume exceeding pericardium highlights the importance of these measurements apart from body surface area. The numerical simulation revealed that the angled outflow cannulation resulted in a maximum pressure drop of 1.8 mmHg higher than that of the straight outflow cannulation. With comparable hemolysis index, the shear stress thresholds of angled outflow differ marginally (<5%) from the established pump model. Similar washout behavior between the pump models indicate that the curvature did not introduce stagnation zone.This study demonstrates the anatomic compatibility of the ShuttlePump in patients with biventricular failure, which was achieved by optimizing the outflow cannulation without compromising hemocompatibility. Nevertheless, clinical validation is critical to ensure the clinical applicability of these findings. [ABSTRACT FROM AUTHOR]

This study on veal calf respiratory disease assessed the association between an on-farm clinical scoring system and lung ultrasonography with the postmortem inspection of the lungs. The comparisons allowed the calculation of predictive values of the diagnostic methods. In total, 600 calves on an Austrian veal calf farm were examined at the beginning and the end of the fattening period. Overall, the area under the curve (AUC) for ultrasonographic scores was 0.90 (rsp = 0.78) with a sensitivity (Se) of 0.86. The specificity (Sp) was 0.78, and the positive predictive value (PPV) was 0.74. The AUC for the physical examination was 0.76 (rsp = 0.55) with a Se of 0.64, an Sp of 0.81, and a PPV of 0.69. For the combination of ultrasonography and physical examination, an AUC curve of 0.85 (rsp = 0.69) was calculated. A Se of 0.65 and a Sp of 0.88 with a PPV of 0.73 was calculated. This study concluded that both physical and ultrasonographic examination scoring are reliable examination methods for the detection of lung diseases in veal calves.

Background: This study aims to provide guidance for the use of neoadjuvant and adjuvant systemic therapy in women with newly diagnosed stage II–IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma. Methods: EMBASE, MEDLINE, and Cochrane Library were investigated for relevant systematic reviews and phase III trials. Articles focusing on consolidation and maintenance therapies were excluded. Results: For women with potentially resectable disease, primary cytoreductive surgery, followed by six to eight cycles of intravenous three-weekly paclitaxel and carboplatin is recommended. For those with a high-risk profile for primary cytoreductive surgery, neoadjuvant chemotherapy can be an option. Adjuvant chemotherapy with six cycles of dose-dense weekly paclitaxel plus three-weekly carboplatin can be considered for women of Japanese descent. In women with stage III or IV disease, the incorporation of bevacizumab concurrent with paclitaxel and carboplatin is not recommended for use as adjuvant therapy unless bevacizumab is continued as maintenance therapy. Intravenous paclitaxel plus intraperitoneal cisplatin and paclitaxel can be considered for stage III optimally debulked women who did not receive neoadjuvant chemotherapy. However, intraperitoneal administration of chemotherapy with bevacizumab should not be considered as an option for stage II–IV optimally debulked women. Discussion: The recommendations represent a current standard of care that is feasible to implement and valued by both clinicians and patients.

Rocky Mountain spotted fever (RMSF), a tick-borne illness, can cause serious illness or death even in a healthy individual. Unfortunately, this illness can be difficult to diagnose as symptoms are nonspecific and oftentimes mimic benign viral illnesses. Delayed diagnosis can be detrimental as the timing of antibiotic administration is critical to prevent associated morbidity and mortality. A careful travel and social history can sometimes provide clues to make the diagnosis. Being aware of lesser-known objective findings such as hyponatremia, neurologic derangements, transaminitis, and thrombocytopenia may help raise suspicion for the disease. This is a case of a 72-year-old woman who presented with nonspecific symptoms and hyponatremia without known tick exposure. She was eventually diagnosed with RMSF. The timing of her presentation corresponded with a surge in COVID-19 infections throughout her area of residence, which further complicated her presentation and contributed to a delayed diagnosis.

C86H78F12I2O2P4Pt2, triclinic, P1‾ $P\overline{1}$ (no. 2), a = 11.520(1) Å, b = 12.196(1) Å, c = 15.382(2) Å, α = 73.20(1)°, β = 75.18(1)°, γ = 86.81(1)°, V = 2000.1(4) Å3, Z = 1, R gt(F) = 0.0631, wR ref(F 2) = 0.1759, T = 193(2) K.

Simple Summary: Early diagnosis of lung lesions in calves is crucial for prompt treatment intervention and management of respiratory diseases. Both a physical and a transthoracic ultrasonography scoring at time of entry offers the opportunity to re-evaluate action plans in case of illness and further facilitate implementation of prophylactic management measures e.g., intranasal vaccination. The present study highlights the advantages of an early diagnosis of respiratory diseases on various production parameters of veal calf fattening and offers the opportunity to evaluate the effect of an intranasal vaccine for bovine respiratory diseases (Bovalto® Respi Intranasal). This study evaluated the significance and predictive value of ultrasonographic and physical examination on arrival at an Austrian fattening farm. Treatment frequency and average daily weight gain (ADG) were related to physical and ultrasonographic examination results. Additionally, the effect of an intranasal vaccination in half of the examined calves was studied. The clinical and ultrasonographic health status 600 calves was recorded at the beginning and end of fattening. Half of the calves received an intranasal vaccination (Bovalto® Respi Intranasal). Overall, 44.5% showed an abnormal respiratory scoring (RS) and 56.0% showed signs of respiratory diseases in transthoracic ultrasonography (TUS) at arrival on the farm. For both RS and TUS, a categorization between ILL and HEALTHY was conducted. Results showed lower ADG in ILL calves (RS median: 0.93 kg/d; TUS median: 0.96 kg/d) compared to HEALTHY calves (RS median: 1.01 kg/d; TUS median: 1.01 kg/d). The median ADG was lower in not treated and ILL calves (RS median 0.90 kg/d; TUS: 0.93 kg/d) compared to treated and ILL calves (RS median 1.01 kg/d; TUS: 1.02 kg/d). Vaccination did not affect growth performance or occurrence of ILL, though treatment frequency was lower in VAC calves (17.0% in NVAC; 11.3% in VAC). The implementation of examination protocols for respiratory diseases may have a positive impact on production parameters (e.g., treatment frequency and ADG). [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to examine the test−retest reliability in lower limb muscle strength and rate of torque development (RTD) using isokinetic dynamometry in adults with obesity, with a body mass index (BMI) ≥ 35 kg/m2. Method: Thirty‐two adults with a BMI of 43.8 ± 6.6 kg/m2 eligible for bariatric surgery were enroled in the study. Isokinetic and isometric knee extensor (KE) and flexor (KF) strength were assessed in an isokinetic dynamometer (Biodex 4) during three test sessions separated by 3−7 days. Results: There were no statistical differences in peak KE and KF torque for any test modalities between sessions. Intraclass correlation (ICC) was 0.91−0.94 between sessions 1 and 2 and 0.94−0.97 between sessions 2 and 3. Standard error of measurement (SEM%) and coefficient of variation (CV) ranged across test sessions from 4.3% to 7.3%. KE RTD showed high test−retest reliability following familiarization, with ICC, CV and SEM% values ranging from 0.84 to 0.90, 13.3%−20.3% and 14.6%−24.9%, respectively. Conclusion: Maximal lower limb muscle strength measured by isokinetic dynamometry showed excellent test−retest reliability manifested by small measurement errors and low CV. Reliability was slightly improved by including a familiarization session. KE RTD but not KF RTD demonstrated high test−retest reliability following familiarization. The present data indicate that isokinetic dynamometry can be used to detect even small changes in lower limb muscle strength in adults with obesity. [ABSTRACT FROM AUTHOR]

Background: The management of locally advanced rectal cancer (LARC) relies on a multimodal approach. Neither instrumental work-up nor molecular biomarkers are currently available to identify a risk-adapted strategy. Objectives: We aim to investigate the role of circulating tumor DNA (ctDNA) and its clearance at different timepoints during chemo-radiotherapy (CRT) and correlate them with clinical outcomes. Design: Between November 2014 and November 2019, we conducted a monocentric prospective observational study enrolling consecutive patients with LARC managed with neoadjuvant standard CRT (capecitabine and concomitant pelvic long-course radiotherapy), followed by consolidation capecitabine in selected cases and surgery. Methods: Blood samples for ctDNA were obtained at pre-planned timepoints. We evaluated the correlation of baseline variant allele frequency (VAF) with pathologic complete response (pCR) down-staging, node regression (pN0), event-free survival (EFS), and overall survival (OS). Results: Among 112 screened patients, 61 were enrolled. In all, 38 (62%) had a positive ctDNA at baseline with VAF > 0 and 23 had negative ctDNA (VAF = 0). Among patients with negative ctDNA, 30% had a complete response, while only 13% of positive ctDNA patients had pCR [odds ratio (OR) 0.35 (95% confidence interval (CI): 0.10–1.26), p = 0.11]. Similarly, 96% and 74% of pN0 were observed among negative and positive ctDNA patients, respectively [OR 0.13 (95% CI: 0.02–1.07), p = 0.058]. The presence of a baseline VAF > 0 was associated with a trend toward a lower EFS compared with VAF = 0 patients [hazard ratio (HR) = 2.30, 95% CI: 0.63–8.36, p = 0.21]. Within the limitations of small sample size, no difference in OS was observed according to the baseline ctDNA status (HR = 1.18, 95% CI: 0.35–4.06, p = 0.79). Conclusion: Within the limitations of a reduced number of patients, patients with baseline negative ctDNA seem to show a higher probability of pN0 status and a trend toward improved EFS. Prospective translational studies are required to define the role of ctDNA analysis in the multimodal treatment of LARC. [ABSTRACT FROM AUTHOR]

Abstract Following the spread of the infection from the new SARS-CoV2 coronavirus in March 2020, several surgical societies have released their recommendations to manage the implications of the COVID-19 pandemic for the daily clinical practice. The recommendations on emergency surgery have fueled a debate among surgeons on an international level. We maintain that laparoscopic cholecystectomy remains the treatment of choice for acute cholecystitis, even in the COVID-19 era. Moreover, since laparoscopic cholecystectomy is not more likely to spread the COVID-19 infection than open cholecystectomy, it must be organized in such a way as to be carried out safely even in the present situation, to guarantee the patient with the best outcomes that minimally invasive surgery has shown to have.