Career involvement and family involvement as moderators of relationships between work-family conflict and withdrawal from a profession

This study extended prior analyses by J. H. Greenhaus, K. M. Collins, R. Singh, and S. Parasuraman (1997) by examining relationships between 2 directions of work-family conflict (work-to-family conflict and family-to-work conflict) and withdrawal from public accounting. The sample consisted of 199 members of the American Institute of Certified Public Accountants (135 men and 64 women) who were married or in a long-term relationship and who had 1 or more children. It was found that work-to-family conflict (but not family-to-work conflict) was positively related to withdrawal intentions. In addition, relationships of work-to-family conflict with withdrawal intentions and withdrawal behavior were stronger for individuals who were relatively uninvolved in their careers than for those who were highly involved in their careers. The implications of the findings for future research are discussed.     

Quantitative in vitro to in vivo extrapolation of genotoxicity data provides protective estimates of in vivo dose

Genotoxicity assessment is a critical component in the development and evaluation of chemicals. Traditional genotoxicity assays (i.e., mutagenicity, clastogenicity, and aneugenicity) have been limited to dichotomous hazard classification, while other toxicity endpoints are assessed through quantitative determination of points-of-departures (PODs) for setting exposure limits. The more recent higher-throughput in vitro genotoxicity assays, many of which also provide mechanistic information, offer a powerful approach for determining defined PODs for potency ranking and risk assessment. In order to obtain relevant human dose context from the in vitro assays, in vitro to in vivo extrapolation (IVIVE) models are required to determine what dose would elicit a concentration in the body demonstrated to be genotoxic using in vitro assays. Previous work has demonstrated that application of IVIVE models to in vitro bioactivity data can provide PODs that are protective of human health, but there has been no evaluation of how these models perform with in vitro genotoxicity data. Thus, the Genetic Toxicology Technical Committee, under the Health and Environmental Sciences Institute, conducted a case study on 31 reference chemicals to evaluate the performance of IVIVE application to genotoxicity data. The results demonstrate that for most chemicals considered here (20/31), the PODs derived from in vitro data and IVIVE are health protective relative to in vivo PODs from animal studies. PODs were also protective by assay target: mutations (8/13 chemicals), micronuclei (9/12), and aneugenicity markers (4/4). It is envisioned that this novel testing strategy could enhance prioritization, rapid screening, and risk assessment of genotoxic chemicals.     

The use of the internal mammary vein for central venous access

Purpose: To describe the use of the internal mammary vein as an alternative access for central venous catheters.Methods: We performed a retrospective review of patients who underwent placement of central venous catheters via the internal mammary vein. Patient demographics, indication for venous access, technical success, catheter type, dwell time and indication for exchange or removal were recorded.Results: Placement of central venous catheters via the internal mammary vein was attempted in 11 patients including 8 children (4 males, mean age 5.7 years) and 3 adults. The most common indication was parenteral nutrition in patients with intestinal failure (7/11). Initial needle access of the vein was successful in all patients. Catheter placement was successful in 9 and unsuccessful in 2 patients due to occlusion of the superior vena cava. There were no immediate complications. A total of 20 catheters of various sizes (3–14.5 French) and lengths (8–23 cm) were either placed (n = 12) or exchanged (n = 8). The most common indications for catheter exchange were poor function and malposition (7/8). Four catheters were removed for infection and 4 were accidentally removed. The mean dwell time was 141 days (range 0–963 days) per catheter for a total of 2829 catheter days. The total mean dwell time per patient, including primarily placed and exchanged catheters, was 314 days (range 5–963 days).CONCLUSIONS: The internal mammary vein may provide a safe alternative route for patients who have lost their traditional access veins.     

Expanded populations of surface membrane immunoglobulin light chain-negative B cells in lymph nodes are not always indicative of B-cell lymphoma

Immunophenotypic analysis is useful in distinguishing reactive from neoplastic lymphoproliferations, particularly when tissue is limited or histologic findings are equivocal. Surface membrane immunoglobulin (SmIg) light chain restriction in B cells is especially helpful in documenting clonality, and the loss of SmIg by B cells in extramedullary sites also has been used as a criterion to support the presence of lymphoma. However, we identified 3 cases of benign follicular hyperplasia (in 101 cases analyzed) with profound expansions (56%-88% of the B cells) of SmIg light chain-negative B cells without clonality by immunoglobulin heavy chain gene polymerase chain reaction. Thus, although uncommonly encountered, lack of SmIg light chain expression by B cells should not necessarily be interpreted as indicative of lymphoma. Interestingly, 2 of the 3 patients with these "aberrant" expansions were HIV+, and such patients are at heightened risk for the development of lymphoma. Therefore, there is the potential for misdiagnosing lymphoma if flow cytometric data are interpreted inappropriately in isolation.     

Preliminary experience with anterior cervical microdiscectomy and interbody titanium cage fusion (Novus CT-Ti) in patients with cervical disc disease

BACKGROUND: Although the use of intervertebral fusion after anterior microdiscectomy in cervical disc disease remains controversial, a new surgical device is proposed for use in intervertebral fusion instead of bone graft. METHODS: This retrospective study at the Department of Neurosurgery, Cardarelli Hospital, Naples, from January 1993 to December 1998, compares the results of surgery on 58 patients with anterior microdiscectomy and intervertebral bone graft fusion (Group A) (ADIBG) with a group of 52 patients who underwent anterior microdiscectomy and intervertebral titanium cage fusion (Group B) (ADITC) in cervical radiculopathy and spondylotic myelopathy.In both groups a "radical discectomy" was performed under the operating microscope. In group A, interbody fusion was performed with autologous tricortical bone graft. In group B, a new type of titanium device (Novus CT-Ti) was used (Sofamor Danek Group). RESULTS: There was no collapse or extrusion of the device and no complications at the donor site (the bone fragments used to fill the cage were taken from osteophytes or vertebral body fragments).The use of this device provides immediate stabilization, reduces or eliminates pain, promotes bone fusion between the vertebrae adjacent to the cage by allowing bone growth through the cage, reestablishes and maintains the intervertebral space, reduces the average hospitalization time, and allows a quicker return to work. CONCLUSIONS: Patients who underwent ADITC did well and benefited from the surgery. Those who underwent ADITC did better than those who underwent ADIBG in regard to function, relief from pain, and complications.Early and good stability of the cervical spine seems to be the main advantage of using titanium cages.     

Early clinical outcomes with tocilizumab for severe COVID-19: a two-centre retrospective study

Severe COVID-19 (coronavirus disease 2019) is associated with elevated inflammatory markers, consistent with cytokine release syndrome (CRS). Tocilizumab is an interleukin-6 (IL-6) inhibitor effective in treating CRS secondary to chimeric antigen receptor T-cell (CAR T-cell) therapy. The efficacy of tocilizumab in treating COVID-19 is unknown. This was a retrospective cohort study conducted at two hospitals in northern New Jersey (USA). All patients treated with tocilizumab for confirmed or suspected COVID-19 between 10 March 2020 and 9 April 2020 at the study sites were included. The primary endpoint was clinical improvement on Day 7 after treatment as assessed by respiratory status. Univariate analysis compared data between those who improved and those who did not. A total of 45 severe and critically ill patients treated with tocilizumab for COVID-19 were evaluated. Of the 45 patients, 11 (24.4%), 22 (48.9%) and 12 (26.7%) patients improved, had no change or worsened by Day 7 after treatment, respectively. Lower white blood cell count and lactate dehydrogenase at the time of drug administration as well as shorter time from supplemental oxygen initiation to dosing were significantly associated with clinical improvement in the univariate analysis. In conclusion, tocilizumab administration was associated with a low rate of clinical improvement within 7 days in this cohort of severe and critically ill patients with COVID-19.     

Shrinkage Study and Strength Aspects of Concrete with Foundry Sand and Coconut Shell as a Partial Replacement for Coarse and Fine Aggregate

The demand for natural aggregates (river sand) is increasing day by day, leading to the destruction of the environment, a burden that will be passed on to young people. Further, wastes from various industries are being dumped in landfills, which poses serious environmental problems. In order to ensure sustainability, both the issues mentioned above can be solved by utilizing industrial waste as aggregate replacement in the concrete construction industry. This research is done to find out the results using two substances viz., waste foundry sand (WFS) and coconut shell (CS) substitute for river sand and coarse aggregate. Many researchers have found the maximum benefits of substituted substances used in cement, which has material consistency. This current observation explores these strong waste properties of waste-infused concrete and cement, which experience shrinkage from drying out. The replacement levels for waste foundry sand were varied, between 10%, 20%, and 30%, and for CS, it was 10% and 20%. The experimental outcomes are evident for the strength, which increases by using WFS, whereas the strength decreases by increasing the CS level. The concrete that experiences shrinkage from drying out is included in the waste material, showing a higher magnitude of drying shrinkage than conventional concrete.