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Background: Same day discharge (SDD) may be considered in some patients undergoing minimally invasive adrenalectomy (MIA). Recent studies have demonstrated similar outcomes between SDD and admitted patients; however, most excluded pheochromocytoma and adrenal metastases. This study evaluates 30-day complications and hospital readmission in a large cohort of patients undergoing MIA. Methods: Adult patients undergoing MIA (2010–2020) for benign adrenal disorders, pheochromocytoma, and adrenal metastases were identified within the ACS-NSQIP database. Comparisons between patients having SDD versus admission were performed. Factors associated with 30-day complications and unplanned readmission were evaluated by multivariable regression modeling. Results: Of 7316 patients who underwent MIA, 254 had SDD. Baseline characteristics were similar between groups, although SDD patients had lower ASA class (p < 0.001) and were more likely to undergo MIA for nonfunctioning adenoma or primary aldosteronism (p = 0.001). After adjusting for covariates, higher ASA class and presence of medical comorbidities were associated with increased complications (p < 0.001; p < 0.05) and unplanned readmission (p < 0.001; p < 0.05). Additionally, prolonged operative time was associated with 30-day complications (p < 0.001). Notably, SDD was not associated with increased complications (OR 0.78, 95% CI 0.38–1.61, p = 0.502) or unplanned readmission (OR 0.76, 95% CI 0.35–1.64, p = 0.490). The rate of SDD for MIA increased from 1.48% in 2017 to 10.81% in 2020. Conclusions: Not all patients undergoing MIA should have SDD; however, the current analysis demonstrates a trend toward SDD and supports its safety in select patients with adrenal metastases and benign adrenal disorders including pheochromocytoma. [ABSTRACT FROM AUTHOR]

We tracked adult emperor penguins from Rothschild Island, west Antarctic Peninsula in 2015/2016 during a summer with extensive sea ice of long duration, contrasting with past years of reduced sea ice extent associated with the recent, rapid, warming trend across the region. We fitted ARGOS PTT devices to penguins of unknown breeding status. Of 33 penguins tracked, nine returned to the colony, presumably to provision offspring. Their foraging trips lasted 9.6 ± 3.7 days, with maximum distances of 75 ± 45 km from the colony within coastal waters. Also, 18 instruments transmitted until the initiation of the annual moult. Penguins travelled at ~ 2.3 km h−1 before slowing for moult. Post-moult, some devices continued to transmit, with speeds of ~ 0.8 km h−1, plausibly due to ice drift, which is rapid in this region. Penguins remained within the seasonal sea ice throughout, staying within 100 km of land, and generally within 5 to 10 km of features (open water, polynyas, leads, icebergs) that offered potential access to the ocean. Penguins were unlikely to have been constrained by the extensive sea ice habitat in 2015/2016. Similar habitats would also have been available in most years of the satellite record (since 1979); however, the moult locations in 2015/2016 would not have been available in many years, and penguins would have needed to find alternative moult locations during some years. Despite uncertainties, the moult period is a critical time for emperor penguins, particularly as sea ice declines, potentially affecting adult survival. [ABSTRACT FROM AUTHOR]

Structured observations of parent-child interactions are commonly used in research and clinical settings, but require additional empirical support. The current study examined the capacity of child-directed play, parent-directed play, and parent-directed chore interaction analogs to uniquely predict the development of conduct problems across a 6-year follow-up period. Parent-child observations were collected from 338 families from high-risk neighborhoods during the summer following the child's first-grade year. Participating children were 49.2 % female, 54.4 % white, and 45.6 % black, and had an average age of 7.52 years at the first assessment. Conduct problems were assessed via parent report and teacher report at five assessment points between first grade and seventh grade. Latent growth curve modeling was used to analyze predictors of conduct problem trajectory across this 6-year follow-up period. When race, sex, socioeconomic status, and maternal depressive symptoms were controlled, parental negative attention during child-directed play predicted higher levels of parent-reported conduct problems concurrently and after a 6-year follow-up period. Parental negative attention during child-directed play also predicted higher teacher-reported conduct problems 6 years later. Findings support the use of child-directed play and parent-directed chore analogs in predicting longitudinal development of conduct problems. The presence of parental negative attention during child-directed play appears to be an especially important predictor of greater conduct problems over time and across multiple domains. Additionally, the potential importance of task-incongruent behavior is proposed for further study. [ABSTRACT FROM AUTHOR]

Accurate spatial estimation of forest carbon stocks and their spatial uncertainties at local, regional, national, and global scales is a critical step in global carbon cycle modeling and management. This study aimed at enhancing the methods that are currently used in this area by combining plot data from the forest inventory and analysis program of the U.S. Forest Service and free landsat thematic mapper image data. Three mapping methods including linear regression, sequential Gaussian co-simulation, and block co-simulation algorithm were compared with respect to the accuracy of forest carbon stock estimates obtained for a study area in Southern Illinois, USA. The results indicated that although the linear regression resulted in smaller prediction errors than the sequential Gaussian co-simulation and the block co-simulation approaches, it also produced both negative and unreasonably large estimates, which is a serious drawback. Moreover, the sequential Gaussian co-simulation and the block co-simulation produced not only accurate carbon predictions, but also uncertainties for the local estimates. In addition, the block co-simulation approach scaled up both forest carbon stocks and the input uncertainties from finer to coarser spatial resolutions as is required for mapping forest carbon at national and global scales. Thus, the co-simulation and block co-simulation algorithms resolved an important current methodological challenge. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) affects between 2 and 8 % of college students. ADHD is associated with impaired academic, psychological, and social functioning, and with a wide array of negative outcomes including lower GPAs, graduation rates, and self-reported quality of life. The college environment often brings decreased external structure and increased availability of immediate rewards, presenting added demands for behavioral self-regulation-an area in which students with ADHD are already vulnerable. Despite the significant impact of ADHD in college and the unique challenges presented by the college context, virtually no treatment development research has been conducted with this population. In order to provide a framework to guide intervention development, this comprehensive review integrates research from three key domains that inform treatment for college students with ADHD: (1) functional impairment associated with ADHD among college students, (2) etiology of ADHD and the developmental context for ADHD among emerging adults (age 18-24), and (3) treatment outcome research for ADHD among adolescents and adults. A detailed set of proposed treatment targets and intervention principles are identified, and key challenges associated with treatment development in this population are discussed. [ABSTRACT FROM AUTHOR]

A number of recent publications have assessed the outcome on leaf development of targeted manipulation of cell proliferation. The results of these investigations have awakened interest in the long-standing debate in plant biology on the precise role of cell division in morphogenesis. Does cell proliferation drive morphogenesis (cell theory) or is it subservient to a mechanism which acts at the whole organ level to regulate morphogenesis (organismal theory)? In this review, the central role of growth processes (distinct from cell proliferation) in morphogenesis is highlighted and the limitations in our understanding of the basic mechanisms of plant growth control are highlighted. Finally, an attempt is made to demonstrate how sequential local co-ordination of growth might provide an interpretation of some of the recent observations on cell proliferation and leaf morphogenesis. [ABSTRACT FROM AUTHOR]

All cells of an adult plant are ultimately derived from divisions that occur in small groups of cells distributed throughout the plant, termed meristems. A new study shows that carbohydrate post-translational modification of a peptide signal influences meristem and, as a consequence, fruit size in tomato. [ABSTRACT FROM AUTHOR]

Tillering and yield are linked in rice, with significant efforts being invested to understand the genetic basis of this phenomenon. However, in addition to genetic factors, tillering is also influenced by the environment. Exploiting experiments in which seedlings were first grown in elevated CO2 (eCO2) before transfer and further growth under ambient CO2 (aCO2) levels, we found that even moderate exposure times to eCO2 were sufficient to induce tillering in seedlings, which was maintained in plants grown to maturity plants in controlled environment chambers. We then explored whether brief exposure to eCO2 (eCO2 priming) could be implemented to regulate tiller number and yield in the field. We designed a cost-effective growth system, using yeast to increase the CO2 level for the first 24 days of growth, and grew these seedlings to maturity in semi-field conditions in Malaysia. The increased growth caused by eCO2 priming translated into larger mature plants with increased tillering, panicle number, and improved grain filling and 1000 grain weight. In order to make the process more appealing to conventional rice farmers, we then developed a system in which fungal mycelium was used to generate the eCO2 via respiration of sugars derived by growing the fungus on lignocellulosic waste. Not only does this provide a sustainable source of CO2, it also has the added financial benefit to farmers of generating economically valuable oyster mushrooms as an end-product of mycelium growth. Our experiments show that the system is capable of generating sufficient CO2 to induce increased tillering in rice seedlings, leading eventually to 18% more tillers and panicles in mature paddy-grown crop. We discuss the potential of eCO2 priming as a rapidly implementable, broadly applicable and sustainable system to increase tillering, and thus yield potential in rice. [ABSTRACT FROM AUTHOR]

Parental depression places offspring at elevated risk for multiple, co-occurring problems. The purpose of this study was to develop and preliminarily evaluate Project Hope, a family intervention for the prevention of both depression and substance use among adolescent-aged children ( M = 13.9 years) of depressed parents. The program was created by blending two empirically supported interventions: one for depression and another for substance use. Thirty families were randomly assigned to either Project Hope ( n = 16) or a wait-list control condition ( n = 14). Pretests, posttests ( n = 29), and 5-month follow-ups ( n = 28) were conducted separately with parents and youth via phone interviews. Questions asked about the family depression experience, family interactions, family management, coping, adolescent substance use beliefs and refusal skills, adolescent depression, and adolescent substance use. Project Hope was fully developed, manualized, and implemented with a small sample of targeted families. Engagement in the program was relatively high. Preliminary outcome analyses were conducted using 2 (Group) ×3 (Time) analyses of covariance. Results provided some evidence for significant improvements among intervention compared to control participants in indicators of the family depression experience, family management, and coping, and a statistically significant decrease from pretest to posttest in alcohol quantity for intervention compared to control youth. Next steps for this program of research are discussed. [ABSTRACT FROM AUTHOR]

Purpose: To describe critical care patients with COVID-19 across England, Wales and Northern Ireland and compare them with a historic cohort of patients with other viral pneumonias (non-COVID-19) and with international cohorts of COVID-19. Methods: Extracted data on patient characteristics, acute illness severity, organ support and outcomes from the Case Mix Programme, the national clinical audit for adult critical care, for a prospective cohort of patients with COVID-19 (February to August 2020) are compared with a recent retrospective cohort of patients with other viral pneumonias (non-COVID-19) (2017–2019) and with other international cohorts of critical care patients with COVID-19, the latter identified from published reports. Results: 10,834 patients with COVID-19 (70.1% male, median age 60 years, 32.6% non-white ethnicity, 39.4% obese, 8.2% at least one serious comorbidity) were admitted across 289 critical care units. Of these, 36.9% had a PaO2/FiO2 ratio of ≤ 13.3 kPa (≤ 100 mmHg) consistent with severe ARDS and 72% received invasive ventilation. Acute hospital mortality was 42%, higher than for 5782 critical care patients with other viral pneumonias (non-COVID-19) (24.7%), and most COVID-19 deaths (88.7%) occurred before 30 days. Meaningful international comparisons were limited due to lack of standardised reporting. Conclusion: Critical care patients with COVID-19 were disproportionately non-white, from more deprived areas and more likely to be male and obese. Conventional severity scoring appeared not to adequately reflect their acute severity, with the distribution across PaO2/FiO2 ratio categories indicating acutely severe respiratory disease. Critical care patients with COVID-19 experience high mortality and place a great burden on critical care services. [ABSTRACT FROM AUTHOR]

Purpose: Evidence of variation in mortality after surgery may indicate preventable postoperative death. We sought to determine if regional differences in outcome were present in surgical patients admitted to critical care in the UK.Methods: We extracted data on admission characteristics, case mix and outcome of all patients admitted to UK critical care units following surgery for the calendar year of 2009. We also used publicly held data on regional population, volume of surgery and bed provision. Multilevel regression analysis was used to adjust for the effects of case mix and regional critical care bed provision on acute hospital mortality.Results: A total of 16,147 patients admitted to critical care following surgery were included in this analysis. Median odds ratio (MOR) was used to describe regional-level variance in acute hospital mortality. Significant variation was identified (MOR 1.14; 95% CI 1.07, 1.28) and persisted following adjustment for case mix (MOR 1.10; 95% CI 1.04, 1.25) and regional critical care bed provision (MOR 1.09; 95% CI 1.04, 1.24). Critical care bed utilisation (surgical critical care admissions per 100,000 surgical procedures) seemed to better explain this observation (MOR 1.03; 95% CI 1.00, 29.26) and was associated with statistically significant reduction in mortality (OR 0.91; 95% CI 0.85, 0.97; p = 0.01).Conclusion: Significant regional variation in hospital mortality for patients admitted to critical care following surgery was observed. Critical care bed utilisation seemed to better explain this observation and was associated with improved outcome. [ABSTRACT FROM AUTHOR]

A correction to this paper has been published: https://doi.org/10.1007/s00134-021-06413-2 [ABSTRACT FROM AUTHOR]