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Postoperative pancreatic fistulas (POPFs) remain common; POPFs frequently require intervention, termed clinically-relevant POPFs (crPOPFs). Pasireotide is increasingly used to prevent POPF, however, risk factors for POPF in this population remain unexplored.Patients undergoing pancreatectomy with perioperative pasireotide from 2013 to 2020 were identified from our institutional National Surgical Quality Improvement Project database. Logistic regression was utilized to identify risk factors associated with POPF.One-hundred patients were identified; 26 (26%) underwent distal pancreatectomy with the remainder undergoing pancreaticoduodenectomy. Thirty (30%) experienced POPF, with 21 crPOPFs. Only current smoking was significantly associated with crPOPF (OR 3.79, p = 0.04). Of 30 patients with a firm gland, none experienced crPOPF. Twenty-five received a partial course of pasireotide; 7/25 (28%) crPOPFs occurred versus 14/75 (19%) in patients receiving a full course (p = 0.38).Shortened courses of pasireotide do not increase crPOPF risk; selective discontinuation may be suitable in low-risk patients. Smoking cessation should be encouraged.

Postoperative pancreatic fistula (POPF) is a feared complication in pancreatic resection. Gravity drainage (GD) is hypothesized to reduce POPF versus closed-suction drainage (CSD). We sought to evaluate this theory.Six-hundred-twenty-nine patients undergoing pancreatic resection between 2013 and 2020 were analyzed with multivariable logistic regression for the outcomes of POPF and clinically-relevant POPF (crPOPF).Three-hundred-ninety-seven patients (63.1%) underwent pancreaticoduodenectomy and 232 (36.9%) underwent distal pancreatectomy. Suction drains were placed in 588 patients (93.5%) whereas 41 (6.5%) had GDs. One-hundred-twenty-five (27.6%) experienced a POPF; 49 (10%) crPOPFs. On multivariable analysis, suction drainage was not associated with increased risk of POPF (OR 0.76, 95% CI 0.30-1.93, P = 0.57) or crPOPF (OR 0.99, 95% CI 0.30-3.26, P = 0.98).Suction drainage does not promote POPF when compared to GDs. Drain type should be determined by surgeon preference, while taking into account nursing and patient-specific considerations especially when patients are discharged with drains.

Domestic abuse is widespread and disproportionately affects women. However, it can affect anybody, regardless of gender, sexuality and socioeconomic status. This includes healthcare professionals, who are often tasked with the responsibility to identify and respond to domestic abuse among their patients. Recent research suggests that healthcare professionals may be more likely to experience domestic abuse than people in the general population: this research also indicates that healthcare staff members are less able to seek support.

Nonuniform array geometries provide freedom for increased aperture and reduced mutual coupling. A necessary and sufficient condition is given for an array of isotropic sensor elements to be unambiguous for any specified set of directions of arrival. The set of unambiguous spatial frequencies is shown to be a parallelepiped, admitting simple geometrical interpretation. Results are used in design of linear, planar, and 3D arrays.

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Many sex worker populations face high morbidity and mortality, but data are scarce on interventions to improve their health. We did a systematic review of health and social interventions to improve the health and wider determinants of health among adult sex workers in high-income countries. We searched MEDLINE, Embase, PsycINFO, CINAHL, the Cochrane Library, Web of Science, EthOS, OpenGrey, and Social Care Online, as well as the Global Network of Sex Work Projects and the Sex Work Research Hub for studies published between Jan 1, 2005 and Dec 16, 2021 (PROSPERO CRD42019158674). Quantitative studies reporting disaggregated data for sex workers were included and no comparators were specified. We assessed rigour using the Quality Assessment Tool for Quantitative Studies. We summarised studies using vote counting and a narrative synthesis. 20 studies were included. Most reported findings exclusively for female sex workers (n=17) and street-based sex workers (n=11). Intervention components were divided into education and empowerment (n=14), drug treatment (n=4), sexual and reproductive health care (n=7), other health care (n=5), and welfare (n=5). Interventions affected a range of mental health, physical health, and health behaviour outcomes. Multicomponent interventions and interventions that were focused on education and empowerment were of benefit. Interventions that used peer design and peer delivery were effective. An outreach or drop-in component might be beneficial in some contexts. Sex workers who were new to working in an area faced greater challenges accessing services. Data were scarce for male, transgender, and indoor-based sex workers. Co-designed and co-delivered interventions that are either multicomponent or focus on education and empowerment are likely to be effective. Policy makers and health-care providers should improve access to services for all genders of sex workers and those new to an area. Future research should develop interventions for a greater diversity of sex worker populations and for wider health and social needs.

Temperature measurements of galaxy clusters are used to determine their masses, which in turn are used to determine cosmological parameters. However, systematic differences between the temperatures measured by different telescopes imply a significant source of systematic uncertainty on such mass estimates. We perform the first systematic comparison between cluster temperatures measured with Chandra and NuSTAR. This provides a useful contribution to the effort of cross-calibrating cluster temperatures due to the harder response of NuSTAR compared with most other observatories. We measure average temperatures for 8 clusters observed with NuSTAR and Chandra. We fit the NuSTAR spectra in a hard (3-10 keV) energy band, and the Chandra spectra in both the hard and a broad (0.6-9 keV) band. We fit a power-law cross-calibration model to the resulting temperatures. At a Chandra temperature of 10 keV, the average NuSTAR temperature was $(10.5 \pm 3.7)\%$ and $(15.7 \pm 4.6)\%$ lower than Chandra for the broad and hard band fits respectively. We explored the impact of systematics from background modelling and multiphase temperature structure of the clusters, and found that these did not affect our results. Our sample are primarily merging clusters with complex thermal structures so are not ideal calibration targets. However, given the harder response of NuSTAR it would be expected to measure a higher average temperature than Chandra for a non-isothermal cluster, so we interpret our measurement as a lower limit on the difference in temperatures between NuSTAR and Chandra., 12 pages plus appendices. Accepted for publication in MNRAS

Background Oxidative stress and chronic inflammation have been demonstrated to contribute to cognitive decline in older age and the development of neurodegenerative disorders. Antioxidants have been revealed to help mitigate the effects of the damage caused by oxidative stress and inflammation, but their relationship with cognitive decline is not yet fully understood. The aim of this study was to investigate the association between various plasma antioxidant levels and cognitive status in participants from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study. Methods 10,600 men were recruited to the PRIME study between 1991-1993 and have been followed up across eleven time points. Baseline health and lifestyle characteristics were assessed, and plasma antioxidants were obtained and quantified. Baseline cognitive status was screened in 2000 using Mini-Mental State Examination (MMSE). Follow up assessment of cognitive status was performed in 2015 with MMSE and Addenbrooke’s Cognitive Examination-Revised (ACE-R) examinations. Results 2,009 men underwent cognitive assessment in 2000 and 873 men in 2015. At both 2000 and 2015 with the use of the MMSE and ACE-R examinations to assess cognitive status, serum concentration of all the antioxidants except for gamma-tocopherol and lycopene were higher in the men with better cognitive performance at a significant level of p Conclusion The findings suggest that the concentration of plasma antioxidants is associated with cognitive status. Smoking and education, as well as other lifestyle factors were, demonstrated to have an impact on cognitive status.

DNA sequencing of specimens of Pseudantechinus found on Australian Wildlife Conservancy’s Mornington Wildlife Sanctuary in the Kimberley region of Western Australia revealed the existence of two species, Ps. macdonnellensis and Ps. ningbing. This is the first record of Ps. macdonnellensis from the Kimberley.

Cytokinins regulate diverse aspects of plant growth and development, primarily through modulation of gene expression. The cytokinin-responsive transcriptome has been thoroughly described in dicots, especially Arabidopsis, but much less so in monocots. Here, we present a meta-analysis of five different transcriptomic analyses of rice (Oryza sativa) roots treated with cytokinin, including three previously unpublished experiments. We developed a treatment method in which hormone is added to the media of rice seedlings grown in sterile hydroponic culture under a continuous airflow, which resulted in minimal perturbation of the seedlings, thus greatly reducing changes in gene expression in the absence of exogenous hormone. We defined a core set of 205 upregulated and 86 downregulated genes that were differentially expressed in at least three of the transcriptomic datasets. This core set includes genes encoding the type-A response regulators (RRs) and cytokinin oxidases/dehydrogenases, which have been shown to be primary cytokinin response genes. GO analysis revealed that the upregulated genes were enriched for terms related to cytokinin/hormone signaling and metabolism, while the downregulated genes were significantly enriched for genes encoding transporters. Variations of type-B RR binding motifs were significantly enriched in the promoters of the upregulated genes, as were binding sites for other potential partner transcription factors. The promoters of the downregulated genes were generally enriched for distinct cis-acting motifs and did not include the type-B RR binding motif. This analysis provides insight into the molecular mechanisms underlying cytokinin action in a monocot and provides a useful foundation for future studies of this hormone in rice and other cereals.

This article identifies the principal drivers of Russian military innovation involving five novel nuclear, conventional, or dual-capable delivery systems—Avangard, Burevestnik, Poseidon, Kinzhal, a...