bluuebunny/crossref_metadata_2025 huggingface dataset:
IBC-Oxford University2023_BJSOral_18The Use of Indocyanine Green (ICG) Fluorescence Angiography in Laparoscopic Roux-en-Y Gastric Bypass for Perfusion Assessment and Structure Visualisation
Authors: Latif J , Awan A
Published: December 2023

Introduction

Indocyanine green (ICG) fluorescence angiography (FA) has been utilised in bariatric surgery for assessment of tissue perfusion and blood supply in laparoscopic sleeve gastrectomy (LSG). However, there is limited literature on its use in laparoscopic Roux-en-Y gastric bypass (LRYGB). The aim of this study was to evaluate the use of ICG-FA in LRYGB for qualitative assessment of tissue perfusion and structure identification. These are the first cases utilising ICG-FA in LRYGB to be performed in the United Kingdom.

Methods

Thirty-five patients (12 male, 34%, 23 females, 66%) with median (IQR) age of 45 (38 – 52) years and preoperative median (IQR) BMI 45 (37 – 49) kg/m2 underwent LRYGB with ICG-FA. ICG was administered intravenously according to an agreed protocol. Karl Storz® Image 1 Rubina system with overlay and monochromatic modes was utilised for perfusion assessment. ICGFA was utilised for qualitative assessment of gastric pouch perfusion before and after linear stapled gastro-jejunal anastomosis and visualisation of key anatomical landmarks. The perfusion pattern was assessed by the operating team based on a ICG scoring system (ICG-S), which ranged from 1 (no perfusion) to 4 (excellent perfusion) based on timing following ICG injection and intensity of fluorescence detected in the anatomical structures.

Results

From April 2021 to August 2022, 34 patients underwent primary LRYGB with use of ICG- FA. ICG was utilised in one revisional case. No adverse effects to ICG were observed. ICG-S was 4 in 33 patients. (94%). In two patients (6%), operative strategy was modified based on focal area of no perfusion (ICG score 1) in gastric pouch. ICG-FA helped improve operative safety during division of omentum and in recognition of duodeno-jejunal flexure with fluorescence detection in epiploic vessels and inferior mesenteric vein (IMV) respectively. There were no leaks at a median follow up of 9 months.

Conclusion

ICGFA imaging allows for qualitative assessment of perfusion and identification of critical anatomical landmarks during LRYGB. The technology is safe and its utilisation in LRYGB provides a “real-time image” of gastric pouch perfusion, helping to demonstrate ischaemic or poorly perfused areas with an opportunity to modify operative strategy.
IBC-Oxford University2023_BJSOral_19Prospective Non-Randomized Study comparing the outcomes of Single Anastomosis Sleeve Jejunal Bypass (SASJ) with One Anastomosis Gastric Bypass (OAGB)
Authors: Elbanna M , Abdelsamee K S , Zaher A S , Essam I
Published: December 2023

Background

Single anastomosis Sleeve Jejunal Bypass (SASJ) is a relatively new bariatric/metabolic procedure. It is the single anastomosis modification of the Sleeve Gastrectomy with Bipartition operation developed by Santoro in 2012. Few studies have been published on its efficacy and safety, and fewer studies have been performed comparing its outcome with recognized bariatric procedures.

Patients and Methods

This is a prospective nonrandomized comparative study. Eighty patients were included in the study, 40 patients underwent SASJ and 40 underwent OAGB, in Ain Shams University Hospitals over 12 months between June 2021 and June 2022. Patients were followed up for at least one year. Both groups are compared for operative time, complications, costs, postoperative weight loss, resolution of co-morbidities, and complications.

Results

The one year follow up was completed by 34 patients in the SASJ group, and 38 patients in the OAGB group. The difference in operative time was not statistically significant. Intraoperative bleeding occurred in 3 cases in the OAGB group, one was successfully managed by conservative management and 2 required re-laparoscopy for successful control of bleeding. No leakage occurred in both groups. There was no statistically significant difference in EWL%, as it was 68.6 % ± 7.2 one year after SASJ and 71.3 % ± 5.7 % after OAGB. TWL% was 35.9 % ± 4.2 one year after SASJ and 36.2 % ± 3.8 % after OAGB, with no statistical difference. T2 DM resolution took place in 100% of patients after both procedures. However, bile reflux was higher after SASJ (17.6%, 6/34 patients), as compared to OAGB (13.2 %, 5/38 patients), yet statistically, the difference was not significant.

Conclusion

SASJ is an effective and safe bariatric/metabolic operation. Its outcome is comparable to that of OAGB. It deserves further study.
IBC-Oxford University2023_BJSOral_23Video Presentation: Gastric Clip Bariclip as A New Technique in Bariatric Robotic Surgery
Authors: Maldonado Pintado D G
Published: December 2023

Robotic Bariatric Surgery is a safe and effective way to perform surgical procedures in the obese patient. The gastric Clíp (Bariclip) is a device implemented as a new bariatric technique to treat obesity accepted for the patients since lower BMI. Between many advantages of this procedure, it is a reversible procedure, avoiding to change the anatomy of the stomach and it can be performed as an ambulatory procedure. We present the first Ambulatory Bariatric Robotic Bariclip Procedure in Mexico City Mexico in August 15th, 2022 at Angeles Pedregal Hospital.
IBC-Oxford University2023_BJSOral_25Early outcomes of Long Biliopancreatic Limb Roux-En-Y Gastric Bypass Versus One-Anastomosis Gastric Bypass
Authors: Salman M A , Aboul-Enein M S , Abelsalam A , Nashed G A , Yacoub M , Abdalla A
Published: December 2023

Background

Roux-en-Y gastric bypass (RYGB) is the gold standard in bariatric surgery. The one-anastomosis gastric bypass (OAGB) procedure, first introduced by Dr. Rutledge, has demonstrated a 25% greater weight loss efficiency than the traditional Roux-en-Y gastric bypass (RYGB) procedure due to the substantially longer biliopancreatic limb (BPL).

Aim of the study

The current work aimed to compare the outcomes of OAGB and long BPL RYGB regarding weight loss and comorbidity resolution.

Patients and methods

This randomized controlled trial was done at our institution between September 2019 and January 2021. Patients who were candidates for bariatric surgery were randomly and equally allocated to two groups. Group A underwent OAGB, while group B underwent long BPL RYGB. Patients were followed up for 6 months postoperatively.

Results

This study included 62 patients equally allocated to OAGB or long BPL RYGB, with no dropouts during follow-up. At 6 months, there was no statistically significant difference between the two groups regarding postoperative BMI (P = 0.313) and the EBWL (P = 0.238). There was comparable remission of diabetes mellitus (P = 0.708), hypertension (P = 0.999), OSA (P = 0.999), joint pain (P = 0.999), and low back pain (P = 0.999). Seven patients in the OAGB group experienced reflux symptoms (P = 0.011), which were managed by proton pump inhibitors.

Conclusion

Extending the BPL in RYGB provides weight loss and comorbidity remission comparable to that of OAGB. Some OAGB-related reflux cases remain a concern. However, they were sufficiently controlled with PPIs. Due to OAGB superior technical simplicity, long BPL RYGB should be preserved for cases who at higher risk for bile reflux.
IBC-Oxford University2023_BJSOral_26A Novel Classification for Gastric Migration after Sleeve Gastrectomy and a Proposed Algorithm for its Management Based on CT 3D Reconstructions.
Authors: Hanssen A , Sabbag D , Rada A , Marroquin L , Thorné H , Jaramillo M , Hanssen R , Daes J
Published: December 2023

Introduction

Sleeve gastrectomy has become a primary bariatric procedure for obesity treatment, but it is associated with the development of hiatal hernias and gastric migration. This migration can lead to complications such as gastro-oesophageal reflux disease. The study aims to classify and analyse gastric migration patterns after sleeve gastrectomy using 3D reconstructed images and propose an algorithm for management.

Methods

A standardized protocol for assessing post-bariatric surgery anatomy was implemented at Clinica Portoazul, Colombia. CT with 3D reconstruction was performed on 100 patients who had undergone sleeve gastrectomy. Images were analysed for gastric migration, and cases were classified based on the extent and type of herniation.

Results

Out of 100 patients reviewed, 28 (34.1%) had hiatal hernias with varying degrees of gastric migration. Among these patients, 22 (26.8%) had Type 1 hernias (sliding with <1/3 gastric tube herniation), 2 (2.4%) had Type 2 hernias (>1/3 stomach herniated), and 4 (4.9%) had Type 3 hernias (paraesophageal migration).

Discussion

Gastric migration after sleeve gastrectomy is a rare complication with potential serious symptoms. Risk factors include history of hiatal hernia, severe obesity, large gastric pouch, and surgical errors. The proposed classification, based on 3D reconstructed images, provides insight into migration patterns and aids in planning revisional surgery.

Conclusion

Gastric migration after sleeve gastrectomy can be assessed using 3D reconstructed CT images. The proposed classification helps categorize migration types, informing treatment decisions. We used this classification to design an algorithm for gastric migration management after sleeve gastrectomy, considering the identified patterns. Further research is needed to validate the classification and determine its role in treatment planning.
IBC-Oxford University2023_BJSPoster_4Biliopancreatic Limb Length and Patient Satisfaction One Anastomosis Gastric Bypass (Mini-Gastric Bypass-Original Technique)
Authors: Rutledge R
Published: December 2023

Introduction

Daily Food Choices (DFCs) in obesity and Bariatric Surgery (BS) are critical components of patient’s health. The Biliopancreatic Limb (BPL) length in the Mini-Gastric Bypass-Original Technique (MGB-OT) version of the One Anastomosis Gastric Bypass (OAGB) includes a “Tailored" BPLL designed to change the outcome of the operation related to patient needs. The purpose of this study was to investigate the relationship between the impact of the MGB-OT and the "Tailored" BPL length, on weight loss and patient-reported DFCs. The primary hypothesis was that the MGB-OT would be associated with major changes in both DFCs and weight loss and that the “Tailored" BPL length would be associated with both DFCs and weight loss.

Methods

Data from an online patient survey of MGB-OT patients were collected including basic demographics, BPL length, pre and post-operative DFCs and weight loss. Linear regression modelling was used to quantitate the relative association between MGB-OT and the "Tailored" BPL length with DFCs and weight loss.

Results

377 patients had complete responses for evaluation; 72% of patients were female, mean age 48+/-15 range 24-80 years; mean BPL length was 2.0+/-0.3m range 0.9-2.7m, mean preop weight was 131.0+/-24.2 range 86.3-222.5kg, mean post weight was 82.6+/-20.0 range 47.2-193.0, mean weight loss 48.4+/-19.2 range 6.4-119.4 and Percent Total Weight Loss (%TWL) was 36.9%+/-8.0% range 6.4%-53.7%. 90.8% of patients reported %TWL greater than 20%. As reported elsewhere, various measures of weight loss varied linearly related to BPL length. The mean DFCs of Meat, Sugar-Sweetened Beverages and Fatty Foods (Meat, SSBs and FFs respectively) were all higher before MGB-OT and declined post-op. The mean “Bad” Food Choices (Bad DFCs = DFCs Meat+SSBs+FFs) declined from mean of 8.6+/-0.9 to 5.0+/0.7 a Delta “Bad” DFCs of 3.6+/-0.9. Daily DFCs of Fresh Fruit and Vegetables (FFVs) increased, Delta FFVs 1.2+/-0.1. The Delta All DFCs, (Delta Bad+FFVs) was 4.8+/-1.0/day with an estimated Delta of 1,757 “Yearly” Food Choices (YFCs.) The estimated Yearly “Bad” food choices declined from 2,070 YFCs to an estimated 745. Finally, there was a strong linear relation between BPL length and the decline in mean “Bad” daily food choices.

Conclusions

The present study demonstrates that patients report major weight loss following a “Tailored" BPL length in the MGB-OT. Patients also reported declines in “Bad” DFCs (meat, FFs & SSBs) and improvements in FFVs. Yearly projections of these changes suggest both an improvement in quality and a decrease in caloric intake of hundreds of thousands of calories per year. Both these were linearly related to Biliopancreatic limb length. A longer Biliopancreatic Limb Length was associated with greater weight loss and a greater improvement in patient-reported Daily Food Choices.
IBC-Oxford University2023_BJSPoster_7BariClip placement in patient with recurrent hiatal hernia: Is it feasible?
Authors: Alarcón Acosta V , Meneses Rojas C J , Ordaz Contreras A , Pérez Queb A J , López Velázquez L A , Legua Perez G S
Published: December 2023

Obesity is a disease with global distribution that affects a vast majority of the population, it has impact not only in patient’s health but has implications in health systems within the state and country. GERD is highly related with being overweight and obese given that these two pathologies are risk factors for developing GERD and its further complications like Barrett’s oesophagus. There are multiple surgical techniques to treat GERD and obesity, we report the case of a 43-year-old female with reflux symptoms secondary to a recurrent hiatal hernia with a previous laparoscopic Nissen fundoplication.

Obesity is a disease with a global distribution, it affects a vast majority of the population leading to a great number of complications not only for the patient but for the states and countries, the prevalence has doubled in the last 30 years, considering this disease as one of the most important risk factors for developing gastroesophageal reflux and Barrett’s oesophagus. It has been proved that being overweight increases 1.2-3 times the risk of GERD and in patients with obesity the prevalence is up to 37-72%. GERD is a disease that commonly affects the general population, it is difficult to establish the incidence, yet it is reported that approximately 42% of the U.S population has symptoms every month and up to 60% has had symptoms at least once in their lifetime. Laparoscopic Gastroplasty with BariClip should be considered as a restrictive procedure given that has demonstrated to have more restriction than the procedures by endoscopic approach, lasting longer and with the advantage that is reversible, clipping and not cutting the stomach, it is as effective as the laparoscopic sleeve gastrectomy surgery, with minimum complications and the possibility of being performed as an outpatient procedure. This is performed placing a non-adjustable clip vertically 3 cm to the lesser curvature of the stomach.
IBC-Oxford University2023_BJSPoster_8Intragastric Balloon as a Primary Bariatric Endoscopic Therapy for Overweight and Obese Patients in Guatemala
Authors: Vitale M
Published: December 2023

Background

Intragastric balloon (IGB) is a temporary and minimally invasive option for overweight and obesity treatment, acting as a space occupying device which leads to weight loss reducing gastric capacity and inducing satiety.

Objective

Review our intragastric balloon usage as a primary therapy for overweight and obese patients in Guatemala.

Results

The total number of IGB procedures was 70. The mean patient age was 33.8 years, with 84.3% being female. The youngest patient was 16 years old and the oldest was 56 years old. The mean pre procedure BMI was 31.8 kg/m2. The minimum pre procedure BMI was 25.5 kg/m2 and the maximum was 66 kg/m2. The most frequently used balloon was the adjustable fluid-filled balloon Spatz3 totalling 46 implants (66%). This was followed by nonadjustable fluid-filled balloons Silimed (17%) and Orbera (8.5%). The Helioscopie air-filled balloon was used in 8.5% of cases. The overall mean percentage of total body weight loss (TBWL) at 12 months was 14.55% + 8.47%. The minimum percent of TBWL was 3% and the maximum was 34.2%. The failure rate (defined as TBWL <10%) was 6.87% + 2.34%. No serious adverse events were reported. The early removal rate due to intolerance was 4.2% (3/70).

Conclusions

Intragastric balloon as a primary endoscopic bariatric treatment for overweight and obese patients at a one-year period is a safe and effective procedure as compared to the data in the literature.
IBC-Oxford University2023_BJSPoster_12Outcomes of Intra-Gastric Balloon as a first step before bariatric surgery for the treatment of patients with super obesity (BMI>50)
Authors: Manco A , Costa Pinho A , Manuel Oliveira A , Santos Sousa H , Resende F , Silva M , Preto J , da Costa E Lima ,   (CRI-O group)
Published: December 2023

Introduction

The treatment of super obesity, defined as a body mass index (BMI) ≥ 50 Kg/m2, presents several challenges. The best therapeutic strategy is debatable and dependent on each case. The intragastric balloon (IGB) can be used as a "neoadjuvant" therapy before metabolic/bariatric surgery (MBS). The purpose of this study is to evaluate the outcomes and safety profile of the IGB as a first step before MBS for the treatment of super obese patients.

Methods

Retrospective study of all patients with BMI ≥ 50 Kg/m2 submitted to intragastric balloon placement before MBS between 2009 and 2023. Several variables were analysed including weight loss outcomes, adverse events, and complications of IGB. Therapeutic failure of IGB was defined as %TWL< 5 or early removal of IGB due to adverse events.

Results

We identified 74 patients with BMI≥ 50 Kg/m2 that were proposed for intragastric balloon placement prior to bariatric surgery, of which 56 (76%) were women, with a mean age of 43,0 ± 11,8 years. The mean initial BMI was 59,4 ± 5.3 Kg/m2. The intragastric balloon remained in the patient for 7,0 ± 1,4 months. The weight loss up to the moment of subsequent bariatric surgery was 22,5 ± 13,2 Kg and the percentage of total weight loss (%TWL) was 14.4 ± 8.4%. The overall rate of complications was 23% (17), the most frequent being nausea and vomiting, of which 50% (8) led to an emergency service visit and 50% (8) to rehospitalization. Regarding serious complications, 3 were identified: 1 gastric perforation and 2 severe respiratory complications, one of which resulted in mortality. Out of the 74 patients, 9 (12%) did not achieve the pre-established %TWL < 5 and 4 (5%) had to remove the intragastric balloon beforehand.

Conclusion

This study demonstrates that the intragastric balloon is a possible "neoadjuvant" therapeutic strategy in this particularly difficult group of patients, resulting in satisfactory weight loss. However, it has a non-negligible complication rate that should be considered when planning each patient's therapeutic strategy.
IBC-Oxford University2023_BJSPoster_16The burden of emergency re-operations post bariatric surgery: experience from a tertiary centre
Authors: Tase A , Perera M , Aly M , Askari A , Jambulingam P , Whitelaw D , Jain V , Adil T , Al-Taan O , Munasinghe A , Rashid F
Published: December 2023

Background

Although bariatric surgery is available through NHS, lack of funding and long waiting times, lead to patients choosing private care within UK or abroad. This study presents data on emergency re-interventions post bariatric surgery (UK and abroad) at a high-volume centre in UK performing between 330-450 bariatric resections/year.

Methods

Data on all patients undergoing emergency intervention following bariatric surgery between Jan 2018 and Nov 2022 were collected.

Results

A total of 155 patients underwent 201 procedures after having had prior bariatric surgery of whom 79.7% were female. The median age was 43 (IQR 35-50 years) and the median BMI was 35 (IQR 28-45). Roux-En-Y Gastric Bypass (RYGB) and Gastric Band (GB) were the commonest index operations (40% and 24.5% respectively) and 22% had their index procedure outside of the UK. The commonest emergency interventions were OGD (n=13) and re-do jejuno-jejunal anastomosis(n=9). The median length of stay was 4 days (IQR 2-13) with mortality of 2%. Per year, the median number of patients admitted as an emergency was 34 (19-45). However, temporal regression analysis forecasts that admissions will steadily rise to 58 (95% CI 46-76) in 2023, 66 (95% CI 54-79) in 2024 and 75 (95% CI 62-88) in 2025 (p=0.013).

Conclusions

An increasing number of patients are attending our hospital having had surgery in either another unit or abroad. Mathematical forecasting models suggest that the number of patients will likely increase every year in the near future. With increasing demand, emphasis falls on the importance of established regional networks.
‘We Reach out but we Also Expect Something in Return’: Social Work Engaging with Roma People in Temporary Container Homes at the Edge of the City
Authors: Samyn Sophie , Cioarta Ionut , Wagener Martin , Hermans Koen , Roets Griet
Published: December 2023

In this article, we critically explore the research findings of a qualitative study of local social policy and work interventions, called ‘the post-mobile project’ in Ghent, Belgium. The project provided temporary housing for families in container units, accompanied by mandatory integration assistance, and was implemented as a potential solution for Romanian Roma families after the dismantlement of two informal settlements in 2020. Our qualitative study explores the underlying ontological assumptions of the social work interventions in this project, and aims to gain insights into the role of contemporary social work practice in Belgium and its impact on advancing or hindering the pursuit of social justice within this Roma community. The study is based on an ethnography as a multi-method approach. Participant observations are complemented by document analysis, semi-structured interviews and focus groups to gain an in-depth understanding of the divergent experiences and opinions of different stakeholders involved in the interventions. The findings reveal different ontological frameworks regarding the way the social problem is defined, the project’s goals and the principles guiding practice, thus exposing tensions between the local policy-makers and the social justice orientation of social work practitioners.
Identifying interindividual variability of social perception and associated brain anatomical correlations in children with autism spectrum disorder using eye-tracking and diffusion tensor imaging MRI (DTI-MRI)
Authors: Vinçon-Leite Alice , Saitovitch Ana , Lemaître Herve , Rechtman Elza , Boisgontier Jennifer , Fillon Ludovic , Philippe Anne , Rio Marlène , Desguerre Isabelle , Fabre Aurélie , Aljabali Khawla , Boddaert Nathalie , Zilbovicius Monica
Published: December 2023

Even though deficits in social cognition constitute a core characteristic of autism spectrum disorders, a large heterogeneity exists regarding individual social performances and its neural basis remains poorly investigated. Here, we used eye-tracking to objectively measure interindividual variability in social perception and its correlation with white matter microstructure, measured with diffusion tensor imaging MRI, in 25 children with autism spectrum disorder (8.5 ± 3.8 years). Beyond confirming deficits in social perception in participants with autism spectrum disorder compared 24 typically developing controls (10.5 ± 2.9 years), results revealed a large interindividual variability of such behavior among individuals with autism spectrum disorder. Whole-brain analysis showed in both autism spectrum disorder and typically developing groups a positive correlation between number of fixations to the eyes and fractional anisotropy values mainly in right and left superior longitudinal tracts. In children with autism spectrum disorder a correlation was also observed in right and left inferior longitudinal tracts. Importantly, a significant interaction between group and number of fixations to the eyes was observed within the anterior portion of the right inferior longitudinal fasciculus, mainly in the right anterior temporal region. This additional correlation in a supplementary region suggests the existence of a compensatory brain mechanism, which may support enhanced performance in social perception among children with autism spectrum disorder.
Lack of response to conspecific juvenile vocalizations in two avian brood parasites
Authors: Prieto Rocío , De Mársico María Cecilia , Reboreda Juan C , Scardamaglia Romina C
Published: December 2023

Juveniles of interspecific avian brood parasites need to locate and recognize conspecifics to continue their life cycle after being reared by individuals of another species. However, little is known about the recognition mechanisms and cues involved in this critical stage of their lives. It has been proposed that adult parasites could show some kind of parental behavior by actively searching and interacting with conspecific young, which in turn could serve the juveniles to learn and/or reinforce the learning of conspecific characteristics. Since acoustic communication is one of the main channels used by birds, if such form of parental behavior by adult avian brood parasites does exist, adult cowbirds should recognize and respond positively to vocalizations of conspecific juveniles. We experimentally tested whether adult shiny Molothrus bonariensis and screaming M. rufoaxillaris cowbirds respond positively towards acoustic signals of conspecific juveniles using two playback experiments, one conducted in semi-captivity and the other in the field. In both cases, we presented 3 types of playbacks to adults of both cowbird species: vocalizations of shiny cowbird juveniles, vocalizations of screaming cowbird juveniles, and white noise as a control. In the experiment in semi-captivity, no significant differences were found between treatments. In the field experiment, no conspecifics approached the playback area, but hosts of the species whose playback was played were attracted to the loudspeaker. In conclusion, our results do not support the predictions we tested from the parental behavior hypothesis and indicate that adult shiny and screaming cowbirds do not respond positively to acoustic signals of conspecific juveniles, at least not to the type of signals used in our experiments.
Increased cover of native and exotic plants on the rims of harvester ant (Hymenoptera: Formicidae) nests under grazing and drought
Authors: Uhey Derek A , Vissa Sneha , Haubensak Karen A , Ballard Andrew D , Aguilar Mekeilah B , Hofstetter Richard W
Published: December 2023

Harvester ants create habitats along nest rims, which some plants use as refugia. These refugia can enhance ecosystem stability to disturbances like drought and grazing, but their potential role in invasion ecology is not yet tested. Here we examine the effects of drought and grazing on nest-rim refugia of 2 harvester ant species: Pogonomyrmex occidentals and P. rugosus. We selected 4 rangeland sites with high harvester ant nest densities in northern Arizona, USA, with pre-existing grazing exclosures adjacent to heavily grazed habitat. Our objective was to determine whether nest refugia were used by native or exotic plant species for each site and scenario of drought and grazing. We measured vegetation cover on nest surfaces, on nest rims, and at 3 distances (3, 5, and 10 m) from nests. At each site, we sampled 2 treatments (grazed/excluded) during 2 seasons (drought/monsoon). We found that nest rims increased vegetation cover compared with background levels at all sites and in almost all scenarios of treatment and season, indicating that nest rims provide important refugia for plants from drought and cattle grazing. In some cases, plants enhanced on nest rims were native grasses such as blue gramma (Bouteloua gracilis) or forbs such as sunflowers (Helianthus petiolaris). However, nest rims at all sites enhanced exotic species, particularly Russian thistle (Salsola tragus), purslane (Portulaca oleracea), and bull thistle (Cirsium vulgare). These results suggest that harvester ants play important roles in invasion ecology and restoration. We discuss potential mechanisms for why certain plant species use nest-rim refugia and how harvester ant nests contribute to plant community dynamics.
Allocating Human Rights Obligations in the ECHR
Authors: Raible Lea
Published: December 2023

This article asks how to allocate human rights obligations stemming from the European Convention on Human Rights and defends an interpretivist account of human rights based on the values of integrity and equality to answer it. First, it considers the structure of rights and argues that human rights usually require a duty bearer who needs to be identified. Second, the article analyses interest-based theories of human rights and shows that they do not speak to the allocation of duties. Third, I argue that duties can only be allocated relying on a normative principle and that an interpretivist account of human rights allows for underlying values to be identified. Fourth, I show that these values should be understood to be integrity and equality. Finally, the article applies the framework to the judgment in Carter v Russia, showing that an explicitly normative account supplies principled distinctions where other approaches cannot.
Deference, Dignity and ‘Theoretical Crisis’: Justifying ECtHR Rights Between Prudence and Protection
Authors: Heri Corina
Published: December 2023

The present article engages with human rights law’s purported ‘theoretical crisis’, according to which rights—and specifically those in the European Convention on Human Rights (ECHR)—are bereft of a convincing theoretical foundation. In doing so, the article interrogates the use of crisis-oriented language, challenging the very idea of a ‘theoretical crisis’ of rights. Identifying the tension between judicial activism and judicial deference as the source of the crisis narrative, this piece engages with the theoretical foundations of ECHR rights, rejecting binary opposition between opposing moral and political accounts of these rights. It presents an alternative account by framing human rights as capable of combining convincing moral foundations with institutional and political realities. This means melding principle and dynamism, and using moral values to interrogate a human rights law that remains indivisible from its institutional backdrop. Under this account, both the Court’s tools of deference, especially its European consensus doctrine, and the objection of rights inflationism must be subjected to scrutiny. This article straddles theory and practice to allow for a fresh perspective concerning the justification of rights, what is at stake, who bears the burden of restraint, and how current responses to backlash should be re-evaluated.
The Tension between the National and ECHR Human Rights Adjudication: A Normative Account
Authors: Harel Alon
Published: December 2023

This article examines cases of conflicting decisions between the ECHR and State Courts. I argue for ‘discordant adjudicative parity.’ According to discordant adjudicative parity, there are compelling non-instrumental reasons for having both international adjudicative institutions and state adjudicative institutions that can make binding, conflicting decisions. Binding decisions by international adjudicative institutions embody the understanding that human rights are duties rather than decisions that are voluntarily undertaken. State Courts facilitate deliberative engagement on the part of citizens as, ultimately, the citizens are in charge of States’ courts. I use this analysis to justify the principle of subsidiarity in European law.
Dietary glycine supplementation improves the growth performance of 110- to 240-g (phase II) hybrid striped bass (Morone saxatilis ♀× Morone chrysops ♂) fed soybean meal-based diets
Authors: He Wenliang , Li Xinyu , Wu Guoyao
Published: December 2023

We recently reported that supplementing glycine to soybean meal (SBM)-based diets is necessary for optimum growth of 5- to 40-g (phase I) hybrid striped bass (HSB). The present study tested the hypothesis that supplementing glycine to SBM-based diets may enhance the growth of 110- to 240-g (phase II) HSB. HSB (the initial body weight of approximately 110 g) were fed an SBM (58%)-based diet supplemented with 0%, 1%, or 2% of glycine, with l-alanine serving as the isonitrogenous control. There were four tanks per dietary group, with four fish per tank. The fish were fed their respective diets to apparent satiation twice daily. The feed intake and body weight of fish were recorded daily and every 2 wk, respectively. At the end of the 56-d feeding trial, plasma and tissue samples were collected to determine amino acid concentrations and histological alterations, and tissues were used to measure the oxidation of l-glutamate, l-glutamine, l-aspartate, and glycine. Results showed that dietary supplementation with 1% and 2% glycine dose-dependently increased (P < 0.05) the concentration of glycine in the plasma of HSB by 48% and 99%, respectively. Compared with the 0%-glycine group, dietary supplementation with 1% glycine did not affect (P > 0.05) the feed intake of HSB but increased (P < 0.05) their final body weight, weight gain, and gain:feed ratio during the whole period by 13%, 29%, and 21%, respectively. Compared with the 1% glycine group, dietary supplementation with 2% glycine increased (P < 0.05) the feed intake, final body weight, and weight gain of HSB by 13%, 7%, and 14%, respectively. Compared with the 0%-glycine group, fish fed with the 1%-glycine and 2%-glycine diets had a greater (P < 0.05) villus height in the proximal intestine, when compared with the 0%-glycine group. Collectively, these results indicated that SBM-based diets did not provide sufficient glycine for phase II HSB (110 to 240 g) and that dietary glycine supplementation is essential for their optimum growth and intestinal structure.
The twolined spittlebug (Hemiptera: Cercopidae) invades Hawaiʻi: establishment, biology, and management of a destructive forage grass pest
Authors: Wilson Shannon , Thorne Mark S , Wright Mark G , Peck Daniel C , Mack Jennifer , Fukumoto Glen K , Curtiss RT
Published: December 2023

The twolined spittlebug, Prosapia bicincta (Say) (Hemiptera: Cercopidae), is a major economic pest of turfgrass, forage grass, and sugarcane. Native to the southeast United States, it impacts rangelands and the landscape trade by damaging pastures, golf courses, urban landscapes, and lawns. This insect pest was reported and confirmed in Hawaiʻi for the first time in 2016, the first species in the family Cercopidae to invade Hawaiʻi. On Hawaiʻi Island, P. bicincta is severely devastating Hawaiʻi’s beef cattle industry. Since its initial detection, P. bicincta has rapidly expanded its range across an estimated 72,183 ha area on Hawaiʻi Island, and it continues to disperse to new locations. In areas of high infestation, this pest has caused 100% dieback of key pasture grasses for livestock forage, including kikuyu (Pennisetum clandestinum Hochst. Ex Chiov) and pangola (Digitaria eriantha Steud) grasses, leading to the establishment of low-quality forage grasses and weeds. Additionally, this pest may affect the Hawaiʻi landscape trade and impact golf courses, urban landscapes, and homeowners. The taxonomy, detection history, range, biology, ecology, economic damage, and management strategies for P. bicincta are discussed.
“After completing the 2011 population census, I found myself in court for the first time”
Authors: Radojevic Gordana
Published: December 2023

Gordana Radojevic was dismissed from her position as director of the Statistical Office of Montenegro in 2021 and suffered almost 2 years of intense governmental scrutiny and “political disgrace”. The court annulled the decision on her dismissal in August 2023. Having now cleared her name, she shares her story
The Robodebt tragedy
Authors: Trewin Dennis , Fisher Nicholas , Cressie Noel
Published: December 2023

Dennis Trewin, Nicholas Fisher and Noel Cressie describe how a lack of statistical thinking led to mindless government technology and unimaginable stress for half a million Australians – some of whom took their own lives
Falling parachutes: Are politicians becoming more “local”?
Authors: Gandy Rob , Foster Scott
Published: December 2023

As UK political parties gear up for a likely general election in 2024, they are busy selecting the most suitable candidates for each seat. Psephologists say voters prefer their parliamentarians to be “local”, not “parachuted” in – but what does the data teach us? Rob Gandy and Scott Foster catch the Speaker's eye
Lessons in linear regression
Authors: de Carvalho Miguel
Published: December 2023

How do you teach linear regression to pupils aged 12–14? Direct proportionality is the key, advises Miguel de Carvalho. That and some sporting superstars…
Chronic kidney disease and risk of kidney or urothelial malignancy: systematic review and meta-analysis
Authors: Brooks Emily R , Siriruchatanon Mutita , Prabhu Vinay , Charytan David M , Huang William C , Chen Yu , Kang Stella K
Published: December 2023

Background

Chronic kidney disease (CKD) is highly prevalent, affecting approximately 11% of US adults. Multiple studies have evaluated a potential association between CKD and urinary tract malignancies. Summary estimates of urinary tract malignancy risk in CKD patients with and without common co-existing conditions may guide clinical practice recommendations.

Methods

Four electronic databases were searched for original cohort studies evaluating the association between CKD and urinary tract cancers (kidney cancer and urothelial carcinoma) through 25 May 2023, in persons with at least moderate CKD and no dialysis or kidney transplantation. Quality assessment was performed for studies meeting inclusion criteria using the Newcastle-Ottawa Scale. Meta-analysis with a random-effects model was performed for unadjusted incidence rate ratios (IRR) as well as adjusted hazard ratios (aHR) for confounding conditions (diabetes, hypertension and/or tobacco use), shown to have association with kidney cancer and urothelial carcinoma. Sub-analysis was conducted for estimates associated with CKD stages separately.

Results

Six cohort studies with 8 617 563 persons were included. Overall, the methodological quality of the studies was good. CKD was associated with both higher unadjusted incidence and adjusted hazard of kidney cancer (IRR 3.36, 95% confidence interval (CI) 2.32–4.88; aHR 2.04, 95% CI 1.77–2.36) and urothelial cancer (IRR 3.96, 95% CI 2.44–6.40; aHR 1.35, 95% CI 1.22–1.50) compared with persons without CKD. Examining incident urinary tract cancers by CKD severity, risks were elevated in stage 3 CKD (kidney aHR 1.89, 95% CI 1.56–2.30; urothelial carcinoma aHR 1.35, 95% CI 1.20–1.52) as well as in stages 4/5 CKD (kidney cancer aHR 2.30, 95% CI 2.00–2.66; urothelial carcinoma aHR 1.24, 95% CI 1.04–1.49).

Conclusions

Even moderate CKD is associated with elevated risk of kidney cancer and urothelial carcinoma. Providers should consider these elevated risks when managing individuals with CKD, particularly when considering evaluation for the presence and etiology of hematuria.
Arabidopsis Calmodulin-like Proteins CML13 and CML14 Interact with Calmodulin-Binding Transcriptional Activators and Function in Salinity Stress Response
Authors: Hau Bryan , Symonds Kyle , Teresinski Howard , Janssen Abby , Duff Liam , Smith Milena , Benidickson Kirsten , Plaxton William , Snedden Wayne A
Published: December 2023

Eukaryotic cells use calcium ions (Ca2+) as second messengers, particularly in response to abiotic and biotic stresses. These signals are detected by Ca2+ sensor proteins, such as calmodulin (CaM), which regulate the downstream target proteins. Plants also possess many CaM-like proteins (CMLs), most of which remain unstudied. We recently demonstrated that Arabidopsis CML13 and CML14 interact with proteins containing isoleucine/glutamine (IQ) domains, including CaM-binding transcriptional activators (CAMTAs). Here, we show that CaM, CML13 and CML14 bind all six members of the Arabidopsis CAMTA family. Using a combination of in planta and in vitro protein-interaction assays, we tested 11 members of the CaM/CML family and demonstrated that only CaM, CML13 and CML14 bind to CAMTA IQ domains. CaM, CML13 and CML14 showed Ca2+-independent binding to the IQ region of CAMTA6 and CAMTA3, and CAMTA6 in vitro exhibited some specificity toward individual IQ domains within CAMTA6 in split-luciferase in planta assays. We show that cml13 mutants exhibited enhanced salinity tolerance during germination compared to wild-type plants, a phenotype similar to camta6 mutants. In contrast, plants overexpressing CML13-GFP or CML14-GFP in the wild-type background showed increased NaCl sensitivity. Under mannitol stress, cml13 mutants were more susceptible than camta6 mutants or wild-type plants. The phenotype of cml13 mutants could be rescued with the wild-type CML13 gene. Several salinity-marker genes under CAMTA6 control were similarly misregulated in both camta6 and cml13 mutants, further supporting a role for CML13 in CAMTA6 function. Collectively, our data suggest that CML13 and CML14 participate in abiotic stress signaling as CAMTA effectors.
Shifting Attitudes towards Domestic Violence: The Impact of Primary Education on Women’s Marital Outcomes in Benin
Authors: Deschênes Sarah , Hotte Rozenn
Published: December 2023

The paper examines the effect of a primary education program in Benin on women’s marital outcomes. The study leverages a sharp increase in the construction of schools in the 1990s to assess the causal impact of an increase in primary-school supply on primary-school attendance, employment, marital outcomes, and experience and tolerance of intimate partner violence (IPV). Using quasi-experimental geographical and historical variations in the number of schools built, the results indicate that in rural areas the school building program increased the probability of attending primary school and increased the age at marriage and at first child. It decreased the probability that women find domestic violence justified and that they experience emotional IPV. The effects are driven by women’s own increase in education rather than their husbands’.
A Near Real-Time Risk Analytics Algorithm Predicts Elevated Lactate Levels in Pediatric Cardiac Critical Care Patients
Authors: Asfari Ahmed , Wolovits Joshua , Gazit Avihu Z. , Abbas Qalab , Macfadyen Andrew J. , Cooper David S. , Futterman Craig , Penk Jamie S. , Kelly Robert B. , Salvin Joshua W. , Borasino Santiago , Zaccagni Hayden J
Published: December 2023

BACKGROUND:

Postoperative pediatric congenital heart patients are predisposed to develop low-cardiac output syndrome. Serum lactate (lactic acid [LA]) is a well-defined marker of inadequate systemic oxygen delivery.

OBJECTIVES:

We hypothesized that a near real-time risk index calculated by a noninvasive predictive analytics algorithm predicts elevated LA in pediatric patients admitted to a cardiac ICU (CICU).

DERIVATION COHORT:

Ten tertiary CICUs in the United States and Pakistan.

VALIDATION COHORT:

Retrospective observational study performed to validate a hyperlactatemia (HLA) index using T3 platform data (Etiometry, Boston, MA) from pediatric patients less than or equal to 12 years of age admitted to CICU (n = 3,496) from January 1, 2018, to December 31, 2020. Patients lacking required data for module or LA measurements were excluded.

PREDICTION MODEL:

Physiologic algorithm used to calculate an HLA index that incorporates physiologic data from patients in a CICU. The algorithm uses Bayes’ theorem to interpret newly acquired data in a near real-time manner given its own previous assessment of the physiologic state of the patient.

RESULTS:

A total of 58,168 LA measurements were obtained from 3,496 patients included in a validation dataset. HLA was defined as LA level greater than 4 mmol/L. Using receiver operating characteristic analysis and a complete dataset, the HLA index predicted HLA with high sensitivity and specificity (area under the curve 0.95). As the index value increased, the likelihood of having higher LA increased (p < 0.01). In the validation dataset, the relative risk of having LA greater than 4 mmol/L when the HLA index is less than 1 is 0.07 (95% CI: 0.06-0.08), and the relative risk of having LA less than 4 mmol/L when the HLA index greater than 99 is 0.13 (95% CI, 0.12–0.14).

CONCLUSIONS:

These results validate the capacity of the HLA index. This novel index can provide a noninvasive prediction of elevated LA. The HLA index showed strong positive association with elevated LA levels, potentially providing bedside clinicians with an early, noninvasive warning of impaired cardiac output and oxygen delivery. Prospective studies are required to analyze the effect of this index on clinical decision-making and outcomes in pediatric population.
Pathologic Complete Response After Gastric Artery Chemoembolization Combined With Tislelizumab for Neoadjuvant Therapy of Locally Advanced Gastric Cancer: A Case Report
Authors: Lin Yufu , Chen Yabo , Lin Shenggan , Zheng Jingmei , Zhang Xiuping , Gan Lu
Published: December 2023

Gastric cancer is the most common type of gastrointestinal cancer in China which about 80% of patients are locally advanced or advanced when diagnosed. Surgery along brings high recurrence rate for locally advanced gastric cancer (LAGC), and neoadjuvant therapies are needed. The use of programmed cell death-1 (PD-1)/programmed death-ligand 1 inhibitor nowadays improved the disease-free survival for LAGC, however, only <35% of patients achieved pathologic complete response (pCR) after neoadjuvant therapy nowadays. Therefore, new regimens are needed to be investigated. Gastric artery chemoembolization is applied to metastasis gastric cancer and researches showed interventional therapy can enhance the antitumor effect of PD-1 inhibitor. Here, for the first time, we combined gastric artery chemoembolization with tislelizumab (a PD-1 inhibitor) for neoadjuvant therapy of a patient with LAGC. The patient achieved pCR after a D2 resection and tumor regression grade score was 1. After surgery, the patient received tislelizumab 200 mg per 3 weeks, and showed no sign of recurrence after 6 months of follow-up. The study indicated the use of tislelizumab and gastric artery chemoembolization for neoadjuvant therapy may bring a better pCR rate and prognosis of LAGC.
Coronary Stent Infection: A Systematic Review of Literature
Authors: Ayyubi Syed Ahmed Salahuddin , Rehman Ayesha , Fatima Laveeza , Ahmed Muhammad , Rehman Mahboob ur , Zameer Rabia , Malik Jahanzeb
Published: December 2023

Coronary stent infection is a rare yet serious complication of coronary artery stenting, with potentially significant morbidity and mortality. This systematic review aimed to comprehensively assess the available evidence on the diagnosis, management, and outcomes of coronary stent infection. A comprehensive search of electronic databases, including PubMed, Embase, Cochrane Library, and Scopus, was conducted from inception until March 2023, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 1 case series and 41 case reports, covering a cumulative sample size of 44 patients, were included in the analysis. The predominant stent types were drug-eluting stents in 22 studies, bare-metal stents in 3 studies, and a combination of drug-eluting stents and bare-metal stents in 4 studies. Staphylococcus aureus was the predominant identified organism in microbiological profiles. Primary outcomes, including mortality, morbidity, and recurrence rates, were evaluated. The aggregate mortality rate across studies was 18%, underscoring the severity of coronary stent infections. Morbidity ranged from 3% to 60%, with a spectrum of complications such as sepsis, heart failure, and embolic events. Recurrence rates varied from 3% to 33%, emphasizing the importance of effective management. Treatment strategies encompassed antibiotics alone, antibiotics with stent removal, and antibiotics with stent retention, with the duration of antibiotic therapy ranging from 2 weeks to 12 months. The optimal management strategy remains uncertain due to limited high-quality evidence. Early diagnosis and treatment were emphasized as critical factors in improving outcomes. Prophylactic antibiotics during stenting procedures and increased awareness among healthcare providers were suggested as preventive measures.