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ObjectiveOesophageal atresia (OA) is a major anomaly of varying severity. The complexity of surgical correction highly depends on the gap length of missing oesophagus and the presence of a distal fistula. The aim of this study was to identify antenatal sonographic findings associated with presence of a distal fistula and type of surgical repairMethodsPrenatal medical records of neonates postnatally diagnosed with OA were reviewed. Sonographic signs of OA (small/absent stomach, polyhydramnios, oesophageal pouch) and the trimester at sign detection were recorded and compared between (1) OA with and without a distal fistula and (2) early one-step versus delayed two-step anastomosis. Multivariate analysis was performed.ResultsOverall, 80 cases of OA were included. Absence of a distal fistula was significantly associated with higher rates of small/absent stomach (100% vs 28.6%, P<0.0001), oesophageal pouch (100% vs 24.3%, P<0.0001) and severe polyhydramnios (66.7% vs 22.9%, P=0.006), compared with OA with a distal fistula.Cases requiring a delayed two-step repair had higher rates of small/absent stomach (84.2% vs 16.7%, P>0.0001), severe polyhydramnios (47.4% vs 16.7%, P=0.008) and oesophageal pouch (73.7% vs 18.5%, P<0.0001), compared with those corrected in an early one-step anastomosis.Multivariate logistic regression found small/absent stomach and pouch to be significantly and independently associated with a delayed two-step anastomosis.ConclusionOA without a distal fistula is associated with higher rates of prenatal sonographic signs. Both small/absent stomach and a pouch are independently associated with a delayed two-step anastomosis. These findings may help improve antenatal parental counselling regarding the anticipated surgical repair.

IntroductionChildhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality.MethodsProspective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months.ResultsAll-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3–11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality.ConclusionsChildren with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer.

Background Hepatic blood flow is known to decrease during pneumoperitoneum. Studies have shown that such changes affect kidney urinary output through the sympathetic pathway known as the hepatorenal reflex. This study investigated the potential role of the hepatorenal reflex in pneumoperitoneum-induced oliguria. The authors hypothesized that oliguria detectable during pneumoperitoneum is caused by activation of the hepatorenal reflex. Methods Denervation of the sympathetic nervous structure was performed in 15 rats by applying 1 ml of 90 % aqueous phenol solution circumferentially to the portal vein and vena cava area at their entrance to the liver. The same was applied to only the peritoneum in 15 nondenervated rats. After 2 weeks, the rats were divided into three subgroups (5 rats per subgroup) that were exposed respectively to carbon dioxide-induced pneumoperitoneum at 0, 10, and 15 mmHg for 2 h. Statistical analysis was performed using Student’s t test and analyses of variance. Results Denervation did not affect the preinsufflation parameters. The denervated and the nondenervated 0-mmHg subgroups presented with similar parameters. The postinsufflation mean urine output was significantly lower in the nondenervated than in the denervated 10- and 15-mmHg subgroups ( p  = 0.0097). The denervated rats had a final creatinine clearance 29 % lower than the preinsufflation value ( p  = 0.83), whereas the nondenervated animals presented a 79 % drop in creatinine clearance ( p  = 0.02). Conclusion The study findings indicate that the hepatorenal reflex plays an important role in the pathophysiology of oliguria that occurs during pneumoperitoneum in the rat.

We described for the first time a foregut cyst presenting as an umbilical mass in a female infant. The diagnosis was made microscopically. This case illustrates, based on varied histologic findings, the complexity in classifying such cysts, in view of existing terminology.

Intersex individuals, possessing both male and female genital openings, were assessed in two groups-7 and 19 months old-of Australian red claw crayfish (Cherax quadricarinatus). All intersex individuals investigated were functional males, as suggested by their male-like morphology and the presence of testes, sperm ducts, androgenic glands, and viable spermatozoa. When an ovary was present in an intersex individual from either group, the gonadosomatic index, the diameter of the oocytes, and the ovarian cytosolic polypeptide profile were similar to those of immature, pre-vitellogenic females. We conclude that intersexuality in C. quadricarinatus does not indicate a case of protandric sequential hermaphroditism, as previously suggested. The case of intersexuality described here presents a unique model for the study of the role of the androgenic gland in the regulation of sex differentiation in crustaceans.

ABSTRACT Mother-offspring relationships were studied in the red-claw crayfish Cherax quadricarinatus during 3 phases: \"egg-carrying,\" \"hatching,\" and \"release.\" The maternal behavior of 16 females and the dispersal of their young were monitored with a video camera in small- and large-sized aquaria. Time allocated to locomotion, aeration, and cleaning was computed for each phase. During the release phase there was an increase in mobility and a reduction in time devoted to fanning as compared to the egg-carrying and hatching phases. A significant negative linear regression was found between the number of juveniles on the mother and days since release. Mother-offspring association was considerably prolonged under conditions of limited space, resulting in a delay in the next breeding cycle of the female. The implications of this study for the commercial production of red-claw crayfish arc discussed.

This study presents two experiments addressing growth and size variation in fingerling silver perch (Bidyanus bidyanus. In the first experiment, fish close to mean population size were raised either in the presence or absence of five larger fish for 60 days. Mean specific growth rate (SGR) and increases in the coefficient of variation and skewness were lower in the presence of larger fish, indicating a negative effect of large fish on the growth of smaller ones. In the second experiment, fingerlings were graded into groups smaller and larger than the median size of the population and raised in size-sorted groups of 60 large or small fish and mixed groups of 30 fish of each size category, for 60 days. There was no difference in mean SGR among groups, nor between the mixed group ad the weighted mean of the small and large groups. Biomass gain was higher in the mixed groups than in the weighted small-and-large groups, probably due to a slightly lower survival in the groups comprised of large fish. The fact that the effect of large fingerlings on the growth of smaller ones was evident in the first, but not the second, experiment may be attributed to higher size disparity between large and small fingerlings in the first experiment.[PUBLICATION ABSTRACT]

ABSTRACT Mother-offspring relationships were studied in the red-claw crayfish Cherax quadricarinatus during 3 phases: \"egg-carrying,\" \"hatching,\" and \"release.\" The maternal behavior of 16 females and the dispersal of their young were monitored with a video camera in small- and large-sized aquaria. Time allocated to locomotion, aeration, and cleaning was computed for each phase. During the release phase there was an increase in mobility and a reduction in time devoted to fanning as compared to the egg-carrying and hatching phases. A significant negative linear regression was found between the number of juveniles on the mother and days since release. Mother-offspring association was considerably prolonged under conditions of limited space, resulting in a delay in the next breeding cycle of the female. The implications of this study for the commercial production of red-claw crayfish arc discussed.