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1.
PLoS Genet ; 20(1): e1011111, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38206959

RESUMO

Meiosis is a highly conserved feature of sexual reproduction that ensures germ cells have the correct number of chromosomes prior to fertilization. A subset of microtubules, known as the spindle, are essential for accurate chromosome segregation during meiosis. Building evidence in mammalian systems has recently highlighted the unexpected requirement of the actin cytoskeleton in chromosome segregation; a network of spindle actin filaments appear to regulate many aspects of this process. Here we show that Drosophila oocytes also have a spindle population of actin that appears to regulate the formation of the microtubule spindle and chromosomal movements throughout meiosis. We demonstrate that genetic and pharmacological disruption of the actin cytoskeleton has a significant impact on spindle morphology, dynamics, and chromosome alignment and segregation during maturation and the metaphase-anaphase transition. We further reveal a role for calcium in maintaining the microtubule spindle and spindle actin. Together, our data highlights potential conservation of morphology and mechanism of the spindle actin during meiosis.


Assuntos
Actinas , Drosophila , Animais , Fuso Acromático/fisiologia , Meiose , Microtúbulos , Oócitos , Citoesqueleto de Actina , Segregação de Cromossomos , Mamíferos
2.
Lancet ; 401(10375): 503-524, 2023 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-36764315

RESUMO

Despite increasing evidence about the value and importance of breastfeeding, less than half of the world's infants and young children (aged 0-36 months) are breastfed as recommended. This Series paper examines the social, political, and economic reasons for this problem. First, this paper highlights the power of the commercial milk formula (CMF) industry to commodify the feeding of infants and young children; influence policy at both national and international levels in ways that grow and sustain CMF markets; and externalise the social, environmental, and economic costs of CMF. Second, this paper examines how breastfeeding is undermined by economic policies and systems that ignore the value of care work by women, including breastfeeding, and by the inadequacy of maternity rights protection across the world, especially for poorer women. Third, this paper presents three reasons why health systems often do not provide adequate breastfeeding protection, promotion, and support. These reasons are the gendered and biomedical power systems that deny women-centred and culturally appropriate care; the economic and ideological factors that accept, and even encourage, commercial influence and conflicts of interest; and the fiscal and economic policies that leave governments with insufficient funds to adequately protect, promote, and support breastfeeding. We outline six sets of wide-ranging social, political, and economic reforms required to overcome these deeply embedded commercial and structural barriers to breastfeeding.


Assuntos
Aleitamento Materno , Organizações , Lactente , Feminino , Humanos , Criança , Gravidez , Pré-Escolar , Emprego
3.
Global Health ; 20(1): 16, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38388413

RESUMO

BACKGROUND: A major challenge to transforming food systems to promote human health and sustainable development is the global rise in the manufacture and consumption of ultra-processed foods (UPFs). A key driver of this dietary transition is the globalization of UPF corporations, and their organized corporate political activity (CPA) intended to counter opposition and block government regulation. UPF industry CPA and the corporate interest groups who lobby on their behalf have been well described at the national level, however, at the global level, this network has not been systematically characterized. This study aims to map, analyse, and describe this network, and discuss the implications for global food policy action on UPFs, global food governance (GFG), and food systems transformation. METHODS: We conducted a network analysis of the declared interest group memberships of the world's leading UPF corporations, extracted from web sources, company reports, and relevant academic and grey literature. Data on the characteristics of these interest groups were further extracted for analysis, including year founded, level, type, and headquarter location. RESULTS: We identified 268 interest groups affiliated with the UPF industry. The UPF manufacturers Nestlé (n = 171), The Coca-Cola Company (n = 147), Unilever (n = 142), PepsiCo (n = 138), and Danone (n = 113) had the greatest number of memberships, indicating strong centrality in coordinating the network. We found that this network operates at all levels, yet key actors now predominantly coordinate globally through multistakeholder channels in GFG. The most common interest group types were sustainability/corporate social responsibility/multistakeholder initiatives, followed by branding and advertising, and food manufacturing and retail. Most corporate interest groups are headquartered where they can access powerful government and GFG decision-makers, nearly one-third in Washington DC and Brussels, and the rest in capital cities of major national markets for UPFs. CONCLUSIONS: The UPF industry, and especially its leading corporations, coordinate a global network of interest groups spanning multiple levels, jurisdictions, and governance spaces. This represents a major structural feature of global food and health governance systems, which arguably poses major challenges for actions to attenuate the harms of UPFs, and to realising of healthy and sustainable food systems.


Assuntos
Alimento Processado , Opinião Pública , Humanos , Indústrias , Alimentos , Política , Indústria Alimentícia
4.
Am J Dermatopathol ; 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38842394

RESUMO

ABSTRACT: We present the case of a 61-year-old male patient with a history of intracranial IDH-wildtype glioblastoma with an isolated cutaneous metastasis within the previous surgical site scar. The cytomorphology of the cutaneous deposits was reminiscent of metastatic melanoma, which is a differential diagnostic pitfall. The tumor molecular characteristics are described, as these have become essential diagnostic criteria for many central nervous system tumors, along with a discussion of the role of immunohistochemical markers and potential pitfalls in the differential diagnosis of melanoma and poorly differentiated carcinoma. We discuss the biology of metastatic glioblastoma and provide a focused literature review of previous glioblastomas with tumor cell seeding within prior surgical scars.

5.
Am J Dermatopathol ; 46(2): 98-100, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-37982500

RESUMO

ABSTRACT: The distinction between digital papillary adenocarcinoma (DPAC) and benign cutaneous adnexal tumors is clinically important and can be challenging. Poroid hidradenoma frequently occurs at acral sites and can show a number of histological features, which overlap with digital papillary adenocarcinoma. Recent work has shown that YAP1-NUTM1 fusions are frequent in poroid hidradenoma and are associated with nuclear protein in testis (NUT) expression by immunohistochemistry. We evaluated the expression of NUT-1 by immunohistochemistry in 4 cases of DPAC and 4 cases of poroid hidradenoma. Three of 4 cases of poroid hidradenoma showed strong NUT-1 expression, with no staining in any of the cases of DPAC. These results suggest that NUT-1 immunohistochemistry may be a useful additional tool in evaluating this differential diagnosis.


Assuntos
Acrospiroma , Adenocarcinoma Papilar , Carcinoma Papilar , Poroma , Neoplasias das Glândulas Sudoríparas , Masculino , Humanos , Acrospiroma/patologia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/genética , Neoplasias das Glândulas Sudoríparas/metabolismo
6.
J Dairy Sci ; 107(2): 1151-1163, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37769942

RESUMO

This study aimed to identify the pathogens isolated from the milk of cows with clinical mastitis in the subtropical region of Australia and to determine the antimicrobial susceptibility of these bacteria. Thirty dairy herds in the subtropical dairy region were asked to submit milk samples for the first 5 cases of clinical mastitis each month for 12 mo. Samples underwent aerobic culture, and isolates were identified via MALDI-TOF mass spectrometry. Antimicrobial susceptibility was determined for Escherichia coli, Enterococcus spp., Streptococcus agalactiae, Streptococcus uberis, Streptococcus dysgalactiae, Staphylococcus aureus, and non-aureus staphylococci and mammaliicocci (NASM). Between March 2021 and July 2022, 1,230 milk samples were collected. A positive culture result was recorded for 812 (66%) of the milk samples; from these samples, 909 isolates were obtained, including 49 isolates where no identification was possible. The remaining samples were classified as having no growth (16.8%) or as being contaminated (17.2%). The most common isolates with a MALDI-TOF diagnosis (n = 909) were Strep. uberis (23.6%), followed by the NASM group (15.0%). Farms enrolled in the study were in 3 distinct locations within the subtropical dairy region: North Queensland, Southeast Queensland, and Northern New South Wales. Some variation in isolate prevalence occurred between these 3 locations. We found lower odds of a sample being positive for E. coli in North Queensland (odds ratio [OR]: 0.25; 95% confidence interval [CI]: 0.07-0.87) and higher odds in Southeast Queensland (OR: 4.01; 95% CI: 1.96-8.20) compared with the reference, Northern New South Wales. We further found higher odds of Strep. dysgalactiae in North Queensland (OR: 5.69; 95% CI: 1.85-17.54) and Southeast Queensland compared with Northern New South Wales (OR: 3.99; 95% CI: 1.73-9.22). Although some seasonal patterns were observed, season was not significant for any of the analyzed isolates. Farm-level differences in pathogen profiles were obvious. Overall, clinical mastitis pathogens had low levels of resistance to the antimicrobials tested. This research demonstrates that Strep. uberis and the NASM bacterial group are the most common pathogens causing clinical mastitis in the subtropical dairy region. It highlights the importance of understanding pathogenic causes of mastitis at the farm and regional level for targeted control and therapy.


Assuntos
Anti-Infecciosos , Doenças dos Bovinos , Mastite Bovina , Infecções Estreptocócicas , Feminino , Animais , Bovinos , Escherichia coli , Infecções Estreptocócicas/veterinária , Staphylococcus , Leite/microbiologia , Bactérias , Mastite Bovina/microbiologia
7.
J Anim Breed Genet ; 2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38779724

RESUMO

The premise was tested that the additional genetic gain was achieved in the overall breeding objective in a pig breeding program using genomic selection (GS) compared to a conventional breeding program, however, some traits achieved larger gain than other traits. GS scenarios based on different reference population sizes were evaluated. The scenarios were compared using a deterministic simulation model to predict genetic gain in scenarios with and without using genomic information as an additional information source. All scenarios were compared based on selection accuracy and predicted genetic gain per round of selection for objective traits in both sire and dam lines. The results showed that GS scenarios increased overall response in the breeding objectives by 9% to 56% and 3.5% to 27% in the dam and sire lines, respectively. The difference in response resulted from differences in the size of the reference population. Although all traits achieved higher selection accuracy in GS, traits with limited phenotypic information at the time of selection or with low heritability, such as sow longevity, number of piglets born alive, pre- and post-weaning survival, as well as meat and carcass quality traits achieved the largest additional response. This additional response came at the expense of smaller responses for traits that are easy to measure, such as back fat and average daily gain in GS compared to the conventional breeding program. Sow longevity and drip loss percentage did not change in a favourable direction in GS with a reference population of 500 pigs. With a reference population of 1000 pigs or onwards, sow longevity and drip loss percentage began to change in a favourable direction. Despite the smaller responses for average daily gain and back fat thickness in GS, the overall breeding objective achieved additional gain in GS.

8.
Global Health ; 19(1): 3, 2023 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-36631805

RESUMO

INTRODUCTION: Share buybacks, when a corporation buys back its own shares, are recognised as having potentially harmful impacts on society. This includes by contributing to economic inequalities, and by impeding investments with the potential to protect and promote the welfare of various stakeholders. Share buybacks, however, have received minimal analytical attention in the public health literature. This paper aimed to explore the potential influence of share buybacks on population health and health inequity using a socio-ecological determinants of health lens. METHODS: We conducted a descriptive analysis of share buybacks made by corporations listed on United States (US) stock exchanges between 1982 and 2021, using quantitative data sourced from Compustat. We examined annual trends in share buyback expenditure, including comparisons to dividend, net income, capital expenditure, and research and development expenditure data. We then purposively sampled a set of corporations to provide illustrative examples of how share buybacks potentially influence key socio-ecological determinants of health. The examples were: i) three COVID-19 vaccine manufacturers; ii) five of the world's largest fossil fuel corporations; and iii) US car manufacturer General Motors. For these, we conducted an analysis of data from Compustat, company reports and grey literature materials, focusing on key sources of profits and their allocation to share buybacks and particular investments. RESULTS: US-listed corporations spent an estimated US$9.2 trillion in real terms on share buybacks between 2012 and 2021 (nearly 12 times more than from 1982 to 1991). The contribution of share buybacks to total shareholder 'returns' increased from 11% in 1982 to 55% in 2021, with expenditure on shareholder returns increasing considerably relative to capital, research and development expenditure over this period. The three examples illustrated how some corporations have prioritised the short-term financial interests of their shareholders, including via implementing large share buyback programs, over investments with considerable potential to protect and promote the public's health. CONCLUSION: The potentially substantial impacts of share buybacks on health warrant increased research and policy attention. Arguably, more must be done to regulate share buybacks as part of efforts to address the corporate drivers of ill-health and inequity.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Estados Unidos , COVID-19/prevenção & controle , Gastos em Saúde , Renda , Desigualdades de Saúde
9.
Global Health ; 19(1): 18, 2023 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-36906536

RESUMO

BACKGROUND: Corporate power has been recognized as an important influence on food environments and population health more broadly. Understanding the structure of national food and beverage markets can provide important insight into the power held by leading corporations. This study aimed to descriptively analyze the structure of the Canadian food and beverage manufacturing and grocery retailing sectors as of 2020/21. METHODS: Packaged food manufacturers, non-alcoholic beverage manufacturers and grocery retailers with ≥ 1% market share in 2020/21 in Canada as per Euromonitor International were identified and characterized. Proportion of market share held by public vs private, multinational vs national, and foreign multinational companies was assessed for the 3 sectors. The concentration of 14 packaged food, 8 non-alcoholic beverage and 5 grocery retailing markets was assessed using the Herfindahl-Hirschman Index (HHI) and the four firm concentration ratio (CR4) (HHI > 1800 and CR4 > 60 suggest high market concentration). Company ownership structure was also assessed, including common ownership of public companies by three of the largest global asset managers using data from Refinitiv Eikon, a financial market database. RESULTS: The Canadian non-alcoholic beverage manufacturing sector, and, to a lesser extent, the packaged food manufacturing sector were dominated by foreign multinational companies, in contrast with the grocery retailing sector which was dominated by national companies. Market concentration varied across sectors and markets but was substantially greater within the retailing (median CR4 = 84; median HHI = 2405) and non-alcoholic beverage sectors (median CR4 = 72; median HHI = 1995) compared to the packaged food sector (median CR4 = 51; median HHI = 932). There was considerable evidence of common ownership across sectors. Overall, the Vanguard Group Inc owned at least 1% of shares in 95% of publicly listed companies, Blackrock Institutional Trust Company 71%, and State Street Global Advisors (US) 43%. CONCLUSIONS: The Canadian packaged food and non-alcoholic beverage manufacturing and grocery retailing sectors include several consolidated markets, with a high degree of common ownership by major investors. Findings suggest that a small number of large corporations, particularly in the retailing sector, have extensive power to influence Canadian food environments; their policies and practices warrant substantial attention as part of efforts to improve population diets in Canada.


Assuntos
Alimentos , Saúde Pública , Humanos , Canadá , Bebidas , Marketing
10.
Global Health ; 19(1): 85, 2023 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-37957671

RESUMO

BACKGROUND: In recent decades there has been a global rise in consumption of ultra-processed foods (UPFs) to the detriment of population health and the environment. Large corporations that have focused heavily on low-cost manufacturing and extensive marketing of UPFs to maximise profits have driven this dietary transition. The same corporations claim to serve the interests of multiple 'stakeholders', and that they are contributing to sustainable development. This paper aimed to test these claims by examining the degree to which UPF corporations have become 'financialised', focusing on the extent to which they have prioritised the financial interests of their shareholders relative to other actors, as well as the role that various types of investors have played in influencing their governance. Findings were used to inform discussion on policy responses to improve the healthiness of population diets. METHODS: We adopted an exploratory research design using multiple methods. We conducted quantitative analysis of the financial data of U.S. listed food and agricultural corporations between 1962 and 2021, share ownership data of a selection of UPF corporations, and proxy voting data of a selection of investors between 2012 and 2022. We also conducted targeted narrative reviews using structured and branching searches of academic and grey literature. RESULTS: Since the 1980s, corporations that depend heavily on manufacturing and marketing UPFs to generate profits have been increasingly transferring money to their shareholders relative to their total revenue, and at a level considerably higher than other food and agricultural sectors. In recent years, large hedge fund managers have had a substantial influence on the governance of major UPF corporations in their pursuit of maximising short-term returns. In comparison, shareholders seeking to take steps to improve population diets have had limited influence, in part because large asset managers mostly oppose public health-related shareholder proposals. CONCLUSIONS: The operationalisation of 'shareholder primacy' by major UPF corporations has driven inequity and undermines their claims that they are creating 'value' for diverse actors. Measures that protect population diets and food systems from the extractive forces of financialisation are likely needed as part of efforts to improve the healthiness of population diets.


Assuntos
Alimento Processado , Saúde Pública , Humanos , Comércio , Dieta , Fast Foods , Manipulação de Alimentos
11.
Am J Dermatopathol ; 45(9): 613-618, 2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37625802

RESUMO

ABSTRACT: The combination of lichenoid and granulomatous inflammation is uncommon in vulval biopsies. We present a series of 5 patients with lichenoid and granulomatous vulvitis, presenting with clinical changes resembling lichen sclerosus. Despite detailed clinicopathological investigation and follow-up, there was no apparent association with an underlying recognized cause. All 5 cases occurred in postmenopausal women and displayed a distinctive histological pattern of superficial band-like inflammation with granulomas "anchored" to the dermoepidermal junction. There was no evidence of deeper granulomatous inflammation. Despite repeated biopsies over 2 years in 2 patients, neither developed typical histological features of lichen sclerosus. We postulate that idiopathic lichenoid and granulomatous vulvitis may represent a distinct clinicopathologically defined vulvar dermatosis.


Assuntos
Líquen Escleroso e Atrófico , Vulvite , Humanos , Feminino , Inflamação , Vulva , Biópsia
12.
Australas J Dermatol ; 64(4): 529-533, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37461361

RESUMO

Sebaceous carcinoma is a rare cutaneous malignancy which is typically regarded as relatively aggressive and has traditionally been subdivided into periorbital or extraorbital tumours. We conducted a retrospective review of all cases of sebaceous carcinoma reported to the Western Australian Cancer Registry between 1987 and May 2019. The incidence of sebaceous carcinoma in Western Australia has increased over the last three decades, with extraorbital tumours being much more common than periorbital tumours. Very few sebaceous carcinomas have led directly to the death of patients; however, adverse outcomes were more likely with periorbital tumours, in particular local recurrence and the need for major surgical intervention.


Assuntos
Adenocarcinoma Sebáceo , Neoplasias das Glândulas Sebáceas , Humanos , Austrália Ocidental/epidemiologia , Austrália/epidemiologia , Adenocarcinoma Sebáceo/epidemiologia , Neoplasias das Glândulas Sebáceas/patologia , Sistema de Registros
13.
Ann Plast Surg ; 90(5): 487-493, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-37146315

RESUMO

OBJECTIVE: The aim of the study is to compare the outcomes of stem cell-enrichment fat grafting versus routine fat grafting for facial reconstruction purposes. METHODS: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses Guidelines and a search of electronic information was conducted to identify all randomized controlled trials, case control studies, and cohort studies comparing the outcomes of stem cell enrichment fat grafting versus routine fat grafting for facial reconstruction purposes. Volume retention and infection rate were primary outcome measures. Secondary outcome measures included patient satisfaction postsurgery, redness and swelling, fat necrosis, cysts, as well as operation time. Fixed and random effects modeling was used for the analysis. RESULTS: Eight studies enrolling 275 subjects were selected. There was a significant difference between the stem cell enrichment fat grafting and routine grafting groups in terms of mean volume retention (standardized mean difference, 2.49; P < 0.00001). However, there was no significant difference between the 2 groups in the rate of infection (odds ratio, 0.36; P = 0.30). For all secondary outcomes, the intervention group had similar results compared with the control group except for the operation time, which was shorter in the latter. CONCLUSIONS: Stem cell-enriched fat grafting is a superior option when compared with the routine fat grafting for facial reconstruction surgery because it improves the mean volume retention and does not worsen patient satisfaction and surgical complications.


Assuntos
Tecido Adiposo , Mamoplastia , Humanos , Tecido Adiposo/transplante , Transplante Autólogo , Mamoplastia/métodos , Satisfação do Paciente , Células-Tronco
14.
Am J Dermatopathol ; 44(8): 607-610, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35385855

RESUMO

ABSTRACT: Deep penetrating nevus (DPN) is a pigmented melanocytic tumor which typically displays a wedge-shaped deep penetrating architecture. Some cases show a coexisting component resembling conventional melanocytic nevus. These morphological attributes are correlated with the acquisition of genomic alterations in the Wnt pathway on a background of underlying activating MAPK pathway mutations. Lesions with features of DPN, but displaying expansile architecture, sheet-like arrangement of cells, cytological atypia, and/or more than rare mitotic activity have been described as "atypical deep penetrating nevus" or "deep penetrating melanocytoma." The molecular correlates of these atypical morphological features are not well-established. In this case report, we describe a tumor in an 8-year-old boy with histological features of atypical DPN showing somatic BRAFV600E , beta catenin , and IDH1R132C mutations. The combination of abnormalities in MAPK and Wnt pathways with IDH1 mutations seems to be a reproducible feature in a subset of atypical DPNs. Whether this "three-hit" combination is associated with a significant risk of adverse outcome remains to be established.


Assuntos
Nevo de Células Epitelioides e Fusiformes , Nevo Pigmentado , Neoplasias Cutâneas , Criança , Humanos , Masculino , beta Catenina/genética , Mutação , Nevo Pigmentado/patologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia
15.
Am J Dermatopathol ; 44(10): 728-733, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-35925552

RESUMO

ABSTRACT: The aim of this study was to review the dermatopathological findings in skin biopsy specimens from pediatric oncology and hematopoietic stem cell transplantation patients over a 20-year period. Three hundred fifty-two skin biopsies from 240 patients were reviewed, and the findings were grouped into 6 categories: index neoplasms, nonindex neoplasms, infections, graft-versus-host disease, other treatment complications, and others. Among the index neoplasms identified on skin biopsy, the most common conditions were Langerhans cell histiocytosis (14 patients) and melanoma (7 patients), with other hematological malignancies and an array of soft-tissue tumors accounting for the bulk of the remainder. Neoplastic conditions common in general dermatopathological practice such as basal cell carcinoma and squamous cell carcinoma were uncommon, each being identified in only 1 patient younger than the age of 18, although basal cell carcinomas developing subsequently in young adult life were identified in 7 patients. Infections were common, with infectious agents or viral cytopathic effects (not including human papillomavirus) identified in 34 biopsies. A significant proportion (74%) represented invasive fungal infections, which are of very significant clinical importance. Biopsies performed for a clinical suspicion of graft-versus-host seldom showed histological features to suggest an alternative diagnosis, with only a single case suggesting a diagnosis of toxic erythema of chemotherapy identified.


Assuntos
Carcinoma Basocelular , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Neoplasias Cutâneas , Biópsia , Carcinoma Basocelular/complicações , Criança , Doença Enxerto-Hospedeiro/patologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Estudos Retrospectivos , Neoplasias Cutâneas/etiologia , Adulto Jovem
16.
Am J Dermatopathol ; 44(11): 846-849, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36075572

RESUMO

ABSTRACT: Merkel cell carcinoma with a sarcomatous component is very rare, with only 12 cases reported in the literature, often with overtly malignant myoid differentiation. We report a case of metastatic Merkel cell carcinosarcoma presenting in a lymph node 6 months after a diagnosis of cutaneous Merkel cell carcinoma with conventional histologic features. The metastatic lesion showed a unique biphasic appearance with admixed populations of neuroendocrine epithelial cells and fascicles of mitotically active spindle cells with mild cytological atypia. In addition to the immunomorphological features, a common molecular profile between the epithelial and mesenchymal components further supported the notion of carcinosarcoma in this case. To the best of our knowledge, a bland sarcomatous component has not been previously described in Merkel cell carcinosarcoma, which can be easily overlooked as a reactive stromal reaction microscopically.


Assuntos
Carcinoma de Célula de Merkel , Carcinossarcoma , Neoplasias Cutâneas , Carcinoma de Célula de Merkel/cirurgia , Carcinossarcoma/patologia , Carcinossarcoma/cirurgia , Humanos , Células de Merkel/patologia , Pele/patologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia
17.
J Vasc Surg ; 73(6): 2144-2153, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33359847

RESUMO

BACKGROUND: Surgical procedures account for 50% of hospital revenue and ∼60% of operating costs. On average, <20% of surgical instruments will be used during a case, and the expense for resterilization and assembly of instrument trays ranges from $0.51 to $3.01 per instrument. Given the complexity of the surgical service supply chain, physician preferences, and variation of procedures, a reduction of surgical cost has been extremely difficult and often ill-defined. A data-driven approach to instrument tray optimization has implications for efficiency and cost savings in sterile processing, including reductions in tray assembly time and instrument repurchase, repair, and avoidable depreciation. METHODS: During a 3-month period, vascular surgery cases were monitored using a cloud-based technology product (OpFlow, Operative Flow Technologies, Raleigh, NC) as a part of a hospital-wide project. Given the diversity of the cases evaluated, we focused on two main vascular surgery trays: vascular and aortic. An assessment was performed to evaluate the exact instruments used by the operating surgeons across a variety of cases. The vascular tray contained 131 instruments and was used for the vast majority of vascular cases, and the aortic tray contained 152 instruments. Actual instrument usage data were collected, a review and analysis performed, and the trays optimized. RESULTS: During the 3-month period, 168 vascular surgery cases were evaluated across six surgeons. On average, the instrument usage per tray was 30 of 131 instruments (22.9%) for the vascular tray and 19 of 152 (12.5%) for the aortic tray. After review, 45.8% of the instruments were removed from the vascular tray and 62.5% from the aortic tray, for 1255 instruments removed from the versions of both trays. An audit was performed after the removal of instruments, which showed that none of the removed instruments had required reinstatement. The instrument reduction from these two trays alone yielded an estimated costs savings of $97,781 for repurchase and $97,444 in annual resterilization savings. Annually, the removal of the instruments is projected to save 316.2 hours of personnel time. The time required for operating room table setup decreased from a mean of 7:44 to 5:02 minutes for the vascular tray (P < .0001) and from 8:53 to 4:56 minutes for the aortic tray (P < .0001). CONCLUSIONS: Given increasing cost constraints in healthcare, sterile processing remains an untapped resource for surgical expense reduction. A comprehensive data analytics solution provided the ability to make informed decisions in tray management that otherwise could not be reliably performed.


Assuntos
Custos Hospitalares , Salas Cirúrgicas/economia , Instrumentos Cirúrgicos/economia , Procedimentos Cirúrgicos Vasculares/economia , Procedimentos Cirúrgicos Vasculares/instrumentação , Computação em Nuvem , Redução de Custos , Análise Custo-Benefício , Reutilização de Equipamento/economia , Humanos , Aprendizado de Máquina , Projetos Piloto , Esterilização/economia , Fatores de Tempo , Fluxo de Trabalho
18.
Int J Behav Nutr Phys Act ; 18(1): 54, 2021 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902639

RESUMO

BACKGROUND: Food environments are influenced by food industries (packaged food and non-alcoholic beverage manufacturers; supermarkets and quick service restaurants). An important source of this influence is the significant market power held by a limited number of food companies. Market structure analysis, as part of a broader market power research agenda, has received limited attention from the public health community. The aim of this study was to analyse similarities and differences in market structure across countries and industries in the European Single Market. METHODS: The companies with the largest market share at the national level for each industry were identified from Euromonitor sales data in 2017/18. The market structure was assessed by the following metrics: the number of global brand owners with ≥1% market share per country, the number of companies unique for one European Single Market member state, the most sold packaged food and non-alcoholic beverage categories, the number of quick-service restaurants and supermarkets per 1000 inhabitants and market concentration by means of the Herfindahl-Hirschman Index (HHI) and the four firm concentration ratio (CR4). CR4-values > 40% and HHI-values > 2000 indicate concentrated markets with limited competition. RESULTS: The leading packaged food and non-alcoholic beverage manufacturers and the most sold food and beverage product categories were similar across countries in Europe. The observed levels of concentration were however different. Average CR4-values ranged from 21 to 72% among packaged food product markets and 60 to 76% for non-alcoholic beverage product markets. Average CR4-values for quick service restaurants and supermarkets were 50 and 60%, respectively. Across European countries the same leading quick-service restaurants were identified, while this was not the case for supermarkets. CONCLUSIONS: This study forms an important basis to understand key aspects of market structure of the European food industry, observing clear differences between food industries and European Single Market member states. This has potential implications for the implementation of food environment policies at different levels of jurisdiction.


Assuntos
União Europeia , Indústria Alimentícia , Bebidas , Comércio , Alimentos , Humanos , Política Nutricional , Saúde Pública , Restaurantes
19.
Genet Sel Evol ; 53(1): 16, 2021 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-33593272

RESUMO

BACKGROUND: Knowledge about potential functional relationships among traits of interest offers a unique opportunity to understand causal mechanisms and to optimize breeding goals, management practices, and prediction accuracy. In this study, we inferred the phenotypic causal networks among five traits in a turkey population and assessed the effect of the use of such causal structures on the accuracy of predictions of breeding values. METHODS: Phenotypic data on feed conversion ratio, residual feed intake, body weight, breast meat yield, and walking score in addition to genotype data from a commercial breeding population were used. Causal links between the traits were detected using the inductive causation algorithm based on the joint distribution of genetic effects obtained from a standard Bayesian multiple trait model. Then, a structural equation model was implemented to infer the magnitude of causal structure coefficients among the phenotypes. Accuracies of predictions of breeding values derived using pedigree- and blending-based multiple trait models were compared to those obtained with the pedigree- and blending-based structural equation models. RESULTS: In contrast to the two unconditioned traits (i.e., feed conversion ratio and breast meat yield) in the causal structures, the three conditioned traits (i.e., residual feed intake, body weight, and walking score) showed noticeable changes in estimates of genetic and residual variances between the structural equation model and the multiple trait model. The analysis revealed interesting functional associations and indirect genetic effects. For example, the structural coefficient for the path from body weight to walking score indicated that a 1-unit genetic improvement in body weight is expected to result in a 0.27-unit decline in walking score. Both structural equation models outperformed their counterpart multiple trait models for the conditioned traits. Applying the causal structures led to an increase in accuracy of estimated breeding values of approximately 7, 6, and 20% for residual feed intake, body weight, and walking score, respectively, and different rankings of selection candidates for the conditioned traits. CONCLUSIONS: Our results suggest that structural equation models can improve genetic selection decisions and increase the prediction accuracy of breeding values of selection candidates. The identified causal relationships between the studied traits should be carefully considered in future turkey breeding programs.


Assuntos
Cruzamento/métodos , Modelos Genéticos , Produtos Avícolas/normas , Característica Quantitativa Herdável , Perus/genética , Animais , Feminino , Aptidão Genética , Genômica/métodos , Masculino , Linhagem , Polimorfismo Genético , Perus/fisiologia
20.
Genet Sel Evol ; 53(1): 61, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34284722

RESUMO

BACKGROUND: Egg production traits are economically important in poultry breeding programs. Previous studies have shown that incorporating genomic data can increase the accuracy of genetic prediction of egg production. Our objective was to estimate the genetic and phenotypic parameters of such traits and compare the prediction accuracy of pedigree-based random regression best linear unbiased prediction (RR-PBLUP) and genomic single-step random regression BLUP (RR-ssGBLUP). Egg production was recorded on 7422 birds during 24 consecutive weeks from first egg laid. Hatch-week of birth by week of lay and week of lay by age at first egg were fitted as fixed effects and body weight as a covariate, while additive genetic and permanent environment effects were fitted as random effects, along with heterogeneous residual variances over 24 weeks of egg production. Predictions accuracies were compared based on two statistics: (1) the correlation between estimated breeding values and phenotypes divided by the square root of the trait heritability, and (2) the ratio of the variance of BLUP predictions of individual Mendelian sampling effects divided by one half of the estimate of the additive genetic variance. RESULTS: Heritability estimates along the production trajectory obtained with RR-PBLUP ranged from 0.09 to 0.22, with higher estimates for intermediate weeks. Estimates of phenotypic correlations between weekly egg production were lower than the corresponding genetic correlation estimates. Our results indicate that genetic correlations decreased over the laying period, with the highest estimate being between traits in later weeks and the lowest between early weeks and later ages. Prediction accuracies based on the correlation-based statistic ranged from 0.11 to 0.44 for RR-PBLUP and from 0.22 to 0.57 for RR-ssGBLUP using the correlation-based statistic. The ratios of the variances of BLUP predictions of Mendelian sampling effects and one half of the additive genetic variance ranged from 0.17 to 0.26 for RR-PBLUP and from 0.17 to 0.34 for RR-ssGBLUP. Although the improvement in accuracies from RR-ssGBLUP over those from RR-PBLUP was not uniform over time for either statistic, accuracies obtained with RR-ssGBLUP were generally equal to or higher than those with RR-PBLUP. CONCLUSIONS: Our findings show the potential advantage of incorporating genomic data in genetic evaluation of egg production traits using random regression models, which can contribute to the genetic improvement of egg production in turkey populations.


Assuntos
Fertilidade , Modelos Genéticos , Característica Quantitativa Herdável , Perus/genética , Animais , Peso Corporal/genética , Ovos/normas , Feminino , Variação Genética , Masculino , Fenótipo , Seleção Artificial , Perus/fisiologia
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