Tag: pubmed

J Robot Surg. 2024 Jun 8;18(1):247. doi: 10.1007/s11701-024-01980-0.

ABSTRACT

Long-term postoperative complications of metabolic and bariatric surgery (MBS) are more frequent than those of primary surgery. Robotic-assisted procedures offer several advantages over traditional laparoscopy, but there are limited data. A retrospective study of 29 patients who underwent a revisional robotic-assisted Roux-en-Y gastric bypass (RRYGB) in a Tertiary Level Hospital. Variables included were demographics, causes for revision, operative details, complications, and weight loss outcomes up to 54 month post-RRYGB. Causes for conversion were weight loss failure (WLF), weight regain (WR), Gastroesophageal Reflux Disease (GERD), or Joint Pain (JP). We assessed 29 patients. Causes for conversion included WLF (34%), WR (15%), WR with GERD (20%), GERD (24%), and JP (3%). Initial BMI was 53.43 kg/m² ± 8.75. Mean length of hospital stay (LOS) was 2 days. Total operative time was 126 min. ± 43.45. Excess weight loss at 1 year post-surgery was 82.66% (p < 0.0001), with mean BMI of 30.93 kg/m² (p < 0.001). At 3 years, mean %EWL was 71.26% and a mean BMI 33.81 kg/m2 (p < 0.0001). At 4.5 years, mean %EWL was 59.29% and mean BMI 37.27 kg/m² (p < 0.0001). One complication (8%) was found (jejunojejunal stenosis). There was no mortality. The initial experience with RRYGB shows acceptable outcomes, including low morbidity, no mortality, excellent weight loss after the revisional surgery, and promising reduction in operative times, with important implications on reduction of the total cost of the procedure.

PMID:38850381 | DOI:10.1007/s11701-024-01980-0

Environ Monit Assess. 2024 Jun 8;196(7):603. doi: 10.1007/s10661-024-12762-4.

ABSTRACT

Ground-level ozone (O₃) pollution has emerged as a significant concern impacting air quality in urban agglomerations, primarily driven by meteorological conditions and social-economic factors. However, previous studies have neglected to comprehensively reveal the spatial distribution and driving mechanism of O₃ pollution. Based on the O₃ monitoring data of 41 cities in the Yangtze River Delta (YRD) from 2014 to 2021, a comprehensive analysis framework of spatial analysis-spatial econometric regression was constructed to reveal the driving mechanism of O₃ pollution. The results revealed the following: (1) O₃ concentrations in the YRD exhibited a general increasing and then decreasing trend, indicating an improvement in pollution levels. The areas with higher O₃ concentration are mainly the cities concentrated in central and southern Jiangsu, Shanghai, and northern Zhejiang. (2) The change of O₃ concentration and distribution is the result of various factors. The effect of urbanization on O₃ concentrations followed an inverted U-shaped curve, which implies that achieving higher quality urbanization is essential for effectively controlling urban O₃ pollution. Traffic conditions and energy consumption have significant direct positive influences on O₃ concentrations and spatial spillover effects. The indirect pollution contribution, considering economic weight, accounted for about 35%. Thus, addressing overall regional energy consumption and implementing traffic source regulations are crucial paths for O₃ pollution control in the YRD. (3) Meteorological conditions play a certain role in regulating the O₃ concentration. Higher wind speed will promote the diffusion of O₃ and increase the O₃ concentration in the surrounding city. These findings provide valuable insights for designing effective policies to improve air quality and mitigate ozone pollution in urban agglomeration area.

PMID:38850374 | DOI:10.1007/s10661-024-12762-4

Indian J Pediatr. 2024 Jun 8. doi: 10.1007/s12098-024-05165-3. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effect of antiepileptic medications prescribed to mothers during pregnancy on the development and behavior of children.

METHODS: From the Kerala Registry of Epilepsy and Pregnancy, 98 children between the ages of 1½ to 2½ y were consecutively chosen. Children of mothers who did not have epilepsy during pregnancy and not exposed to antiseizure medications (ASMs) antenatally were selected as comparator group. Developmental assessment of the children was performed using Developmental Assessment Scale for Indian Infants (DASII) and Receptive-Expressive Emergent Language Scale (REELS). Behavior outcomes were assessed using Child Behavior Checklist.

RESULTS: A significant delay in expressive language skills was seen in children exposed to antiseizure medication with an odds ratio of 2.539 (95% CI 1.10, 5.85, P = 0.026). A delay in expressive language skills was seen in polytherapy with clobazam (odds ratio 6.83; 95% CI 2.17, 21.56, P < 0.001). Also, delay was seen in receptive language skills in the same polytherapy group (odds ratio of 7.333; 95% CI 2.16, 24.92, P < 0.001). There were no statistically significant differences between study and comparative groups in motor and mental quotient domains and behavioral outcomes.

CONCLUSIONS: The finding of speech delay in children exposed to ASMs is significant since individuals with a history of childhood speech or language disorders may experience long-term difficulties in mental health, social well-being, and academic outcomes.

PMID:38850358 | DOI:10.1007/s12098-024-05165-3

ESC Heart Fail. 2024 Jun 8. doi: 10.1002/ehf2.14851. Online ahead of print.

ABSTRACT

BACKGROUND: Heart failure (HF) and malnutrition exhibit overlapping risk factors, characterized by increased levels of natriuretic peptides and an inflammatory profile. The aim of this study was to compare the differences in plasma brain natriuretic peptide (BNP), N-terminal-pro B-type natriuretic peptide (NT-proBNP), and C-reactive protein (CRP) in patients with HF and malnutrition versus normal nutrition.

METHODS: From inception until July 2023, the databases, PubMed, Scopus, Web of Science, and Cochrane Library were searched. To examine the association among malnutrition [controlling nutritional status (CONUT) score ≥2; Geriatric Nutritional Risk Index (GNRI) score <92] with BNP, NT-proBNP and CRP in patients with HF, a meta-analysis using a random-effects model was conducted (CRD42023445076).

RESULTS: A significant association of GNRI with increased levels of BNP were demonstrated [mean difference (MD): 204.99, 95% confidence interval (CI) (101.02, 308.96, I² = 88%, P < 0.01)], albeit no statistically significant findings were shown using CONUT [MD: 158.51, 95% CI (-1.78 to 318.79, I² = 92%, P = 0.05)]. GNRI [MD: 1885.14, 95% CI (1428.76-2341.52, I² = 0%, P < 0.01)] and CONUT [MD: 1160.05, 95% CI (701.04-1619.07, I² = 0%, P < 0.01)] were associated with significantly higher levels of NT-proBNP. Patients with normal GNRI scores had significantly lower levels of CRP [MD: 0.50, 95% CI (0.12-0.88, I² = 87%, P = 0.01)] whereas significantly higher levels of CRP were observed in those with higher CONUT [MD: 0.40, 95% CI (0.08-0.72, I² = 88%, P = 0.01)]. Employing meta-regression, age was deemed a potential moderator between CRP and GNRI.

CONCLUSIONS: Normal nutrition scores in patients with HF are linked to lower BNP, NT-proBNP, and CRP levels compared with malnourished counterparts. Despite the significant link between CRP and malnutrition, their relationship may be influenced in older groups considering the sensitivity of GNRI due to ageing factors.

PMID:38850122 | DOI:10.1002/ehf2.14851

ANZ J Surg. 2024 Jun 8. doi: 10.1111/ans.19107. Online ahead of print.

ABSTRACT

BACKGROUND: We (1) describe West Australian (WA) older adults undergoing emergency laparotomy (EL) in a tertiary-centre Acute Surgical Unit (ASU) with proactive geriatrician input and (2) explore the impact of Clinical Frailty Scale (CFS) and Charlson’s Comorbidity Index (CCI) on patient outcomes.

METHODS: We performed a prospective cohort-study of older adults undergoing EL, between April 2021 and April 2022, in a tertiary ASU, with dedicated geriatrician-led perioperative care via the Older Adult Surgical Inpatient Service (OASIS).

RESULTS: Of 114 patients, average age was 76.7 ± 7.61 years-old (range 65-96), with 35.1% (n = 40) frail (CFS 5-7), 18.4% (n = 21) vulnerable (CFS 4) and 46.5% (n = 74) not frail (CFS 1-3). 61.4% (n = 70) were severely comorbid (CCI ≥5), 34.2% (n = 39) moderately comorbid (CCI 3-4), and 4.4% (n = 5) mildly comorbid (CCI 1-2). 95.9% (n = 109) EL patients were reviewed by OASIS. Inpatient mortality was 7.9% (n = 9) and 1-year mortality 16.7% (n = 19). Majority, 64.9% (n = 74), were discharged directly home with 17.5% (n = 20) discharged with in-home rehabilitation. Each increment in CCI was associated with increased in-hospital (HR 1.38, p = 0.034) and 1-year (HR 1.39, p = 0.006) mortality, and each increment in CFS with 1-year mortality (HR 1.62, p = 0.016). Higher CFS but not CCI was associated with increased level of care at discharge. Age was not statistically significant with any outcomes.

CONCLUSION: We describe demographics, frailty and comorbidity of 114 older adults undergoing EL in ASU. We suggest CFS and CCI as independent risk-stratification tools, and proactive management of both comorbidity, and frailty, should be incorporated into preoperative optimisation.

PMID:38850119 | DOI:10.1111/ans.19107

Mol Ecol Resour. 2024 Jun 8:e13985. doi: 10.1111/1755-0998.13985. Online ahead of print.

ABSTRACT

Despite their critical roles in genetic sex determination, sex chromosomes remain unknown in many non-model organisms, especially those having recently evolved sex-linked regions (SLRs). These evolutionarily young and labile sex chromosomes are important for understanding early sex chromosome evolution but are difficult to identify due to the lack of Y/W degeneration and SLRs limited to small genomic regions. Here, we present SLRfinder, a method to identify candidate SLRs using linkage disequilibrium (LD) clustering, heterozygosity and genetic divergence. SLRfinder does not rely on specific sequencing methods or a specific type of reference genome (e.g., from the homomorphic sex). In addition, the input of SLRfinder does not require phenotypic sexes, which may be unknown from population sampling, but sex information can be incorporated and is necessary to validate candidate SLRs. We tested SLRfinder using various published datasets and compared it to the local principal component analysis (PCA) method and the depth-based method Sex Assignment Through Coverage (SATC). As expected, the local PCA method could not be used to identify unknown SLRs. SATC works better on conserved sex chromosomes, whereas SLRfinder outperforms SATC in analysing labile sex chromosomes, especially when SLRs harbour inversions. Power analyses showed that SLRfinder worked better when sampling more populations that share the same SLR. If analysing one population, a relatively larger sample size (around 50) is needed for sufficient statistical power to detect significant SLR candidates, although true SLRs are likely always top-ranked. SLRfinder provides a novel and complementary approach for identifying SLRs and uncovering additional sex chromosome diversity in nature.

PMID:38850116 | DOI:10.1111/1755-0998.13985

Int J Cancer. 2024 Jun 8. doi: 10.1002/ijc.35050. Online ahead of print.

ABSTRACT

Despite advances in early detection and treatment strategies, breast cancer recurrence and mortality remain a significant health issue. Recent insights suggest the prognostic potential of microscopically healthy mammary gland, in the vicinity of the breast lesion. Nonetheless, a comprehensive understanding of the gene expression profiles in these tissues and their relationship to patient outcomes remain missing. Furthermore, the increasing trend towards breast-conserving surgery may inadvertently lead to the retention of existing cancer-predisposing mutations within the normal mammary gland. This study assessed the transcriptomic profiles of 242 samples from 83 breast cancer patients with unfavorable outcomes, including paired uninvolved mammary gland samples collected at varying distances from primary lesions. As a reference, control samples from 53 mammoplasty individuals without cancer history were studied. A custom panel of 634 genes linked to breast cancer progression and metastasis was employed for expression profiling, followed by whole-transcriptome verification experiments and statistical analyses to discern molecular signatures and their clinical relevance. A distinct gene expression signature was identified in uninvolved mammary gland samples, featuring key cellular components encoding keratins, CDH1, CDH3, EPCAM cell adhesion proteins, matrix metallopeptidases, oncogenes, tumor suppressors, along with crucial genes (FOXA1, RAB25, NRG1, SPDEF, TRIM29, and GABRP) having dual roles in cancer. Enrichment analyses revealed disruptions in epithelial integrity, cell adhesion, and estrogen signaling. This signature, named KAOS for Keratin-Adhesion-Oncogenes-Suppressors, was significantly associated with reduced tumor size but increased mortality rates. Integrating molecular assessment of non-malignant mammary tissue into disease management could enhance survival prediction and facilitate personalized patient care.

PMID:38850108 | DOI:10.1002/ijc.35050

Scand J Med Sci Sports. 2024 Jun;34(6):e14671. doi: 10.1111/sms.14671.

ABSTRACT

The study aimed to assess loneliness experiences among athletes with disabilities (AWD) during the different phases of the pandemic and to understand its relationship with coping styles. Ninety-one AWD participated in a longitudinal study spanning 10 months, covering three time points: April (A), June (Time B), and November (Time C) 2021. The study used the Coping Inventory for Stressful Situations and the revised University of California Los Angeles Loneliness Scale-Revised (UCLA-R) to measure coping mechanisms and feelings of loneliness, respectively. Loneliness levels peaked during the most intense phase of the pandemic, showing significant differences between consecutive time points (χ² = 20.29, p < 0.001, d = 0.24). The most robust regression models were built in Time B, using the “intimate contacts” dimension of loneliness as the dependent variable and “emotion-oriented coping”, “avoidance-oriented coping”, and “impairment” as independent variables, explaining 44% of the variance (p < 0.001). Loneliness among Paralympic athletes fluctuated during various phases of the pandemic. The findings highlight the significant influence of coping styles, particularly emotional styles which heightened perceived loneliness, and task-oriented styles which reduced it, on athletes’ experiences of loneliness. These results underscore the need for longitudinal studies to delve deeper into the relationship between loneliness and mental health. Moreover, they stress the importance of developing tailored interventions that promote effective coping mechanisms in AWD during challenging times amid to COIVID-19.

PMID:38850106 | DOI:10.1111/sms.14671

J Anim Ecol. 2024 Jun 8. doi: 10.1111/1365-2656.14120. Online ahead of print.

ABSTRACT

Marine heatwaves (MHWs) can cause thermal stress in marine organisms, experienced as extreme ‘pulses’ against the gradual trend of anthropogenic warming. When thermal stress exceeds organismal capacity to maintain homeostasis, organism survival becomes time-limited and can result in mass mortality events. Current methods of detecting and categorizing MHWs rely on statistical analysis of historic climatology and do not consider biological effects as a basis of MHW severity. The re-emergence of ectotherm thermal tolerance landscape models provides a physiological framework for assessing the lethal effects of MHWs by accounting for both the magnitude and duration of extreme heat events. Here, we used a simulation approach to understand the effects of a suite of MHW profiles on organism survival probability across (1) three thermal tolerance adaptive strategies, (2) interannual temperature variation and (3) seasonal timing of MHWs. We identified survival isoclines across MHW magnitude and duration where acute (short duration-high magnitude) and chronic (long duration-low magnitude) events had equivalent lethal effects on marine organisms. While most research attention has focused on chronic MHW events, we show similar lethal effects can be experienced by more common but neglected acute marine heat spikes. Critically, a statistical definition of MHWs does not accurately categorize biological mortality. By letting organism responses define the extremeness of a MHW event, we can build a mechanistic understanding of MHW effects from a physiological basis. Organism responses can then be transferred across scales of ecological organization and better predict marine ecosystem shifts to MHWs.

PMID:38850096 | DOI:10.1111/1365-2656.14120

Clin Oral Implants Res. 2024 Jun 8. doi: 10.1111/clr.14314. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this systematic review and meta-analyses was to evaluate the outcomes of alveolar ridge preservation (ARP) following extraction of non-molar teeth in comparison to early implant placement (EIP) in terms of clinical and radiographic changes, need for additional augmentation at the time of implant placement, patient-reported outcomes, and implant failure rate.

METHODS: Electronic databases were searched to identify randomized and non-randomized studies that compared ARP to EIP. The risk of bias was assessed using the Cochrane Collaboration’s Risk of Bias tool. Data were analyzed using a statistical software program.

RESULTS: A total of 106 studies were identified, of which five studies with 198 non-molar extraction sockets in 198 participants were included. Overall meta-analysis showed significant differences in changes in midfacial mucosal margin (mean difference (MD) -0.09; 95% confidence interval (CI) -0.17 to -0.01; p = .03) and ridge width (MD -1.70; 95% CI -3.19 to -0.20; p = .03) in favor of ARP. The use of ARP was also associated with less need for additional augmentation at implant placement, but the difference was not statistically significant.

CONCLUSIONS: Within the limitation of this review, ARP following extraction of non-molar teeth has short-term positive effects on soft tissue contour, mucosal margin and thickness, and alveolar ridge width and height. It can also simplify future implant treatment by minimizing the need for additional augmentation.

PMID:38850092 | DOI:10.1111/clr.14314