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The development of a tailored filament is reported composed of reduced graphene oxide (rGO) and carbon black (CB) in a polylactic acid (PLA) matrix and its use in the production of electrochemical sensors. The electrodes containing rGO showed superior performance when compared with those prepared in the absence of this material. Physicochemical and electrochemical characterizations of the electrodes showed the successful incorporation of both rGO and CB and an improved conductivity in the presence of rGO (lower resistance to charge transfer). As a proof-of-concept, the developed electrodes were applied to the detection of the forensic analytes TNT and cocaine. The electrodes containing rGO presented a superior analytical performance for both TNT and cocaine detection, showing the lower limit of detection values (0.22 and 2.1 µmol L−1, respectively) in comparison with pure CB-PLA electrodes (0.93 and 11.3 µmol L−1, respectively). Besides, better-defined redox peaks were observed, especially for TNT, as well as increased sensitivity for both molecules. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the psychometric properties of the Niigata Questionnaire (NPQ) for use in a European population with persistent postural-perceptual dizziness (PPPD). Methods: Observational study included 140 patients with different vestibular conditions. Construct validity, internal consistency and concurrent validity were analyzed. Intra-class correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated. Receiver operating characteristic (ROC) curve was used to test diagnostic values. Results: Of the 140 patients, 47 had a diagnosis of PPPD. Factorial analysis showed a single-factor structure and concurrent validity analysis showed strong correlations with other instruments. Cronbach alpha coefficients of 0.938 for the total score, 0.869 for the standing and gait subscale, 0.803 for the subscale of movements and 0.852 for the visual stimulation subscale were obtained. The reproducibility was substantial except for the standing subscale, which could be considered moderate. For the standing, movement and visual stimulation subscales and for the total score, the SEM was 3.27, 2.41, 2.50 and 6.63, respectively, and the MDC was 6.40, 4.72, 4.91 and 12.99, respectively. The NPQ total score showed an area under the curve (AUC) of 0.661, a sensitivity of 72.34 and a specificity of 55.91 for discriminating between PPPD and other vestibular disorders. Conclusions: The NPQ is feasible for use in a Western population and presents a uni-factorial structure, high internal consistency and strong correlation with other instruments. The reliability can be considered substantial. The NPQ has low accuracy in discriminating between subjects with or without PPPD. [ABSTRACT FROM AUTHOR]

This document discusses the development of sustainable and economical platforms for electrochemical sensing using micro- and nanotechnologies. The use of micro- and nanomaterials has proven to be essential in creating selective and sensitive sensing devices for various applications. The document highlights the importance of sustainability and accessibility in the production of sensing devices, particularly for developing countries. It also provides examples of successful platforms, such as paper-based analytical devices, and discusses the latest advances in the field. The document emphasizes the connection between these developments and the United Nations' sustainable development goals, including goals related to health, responsible consumption and production, clean water, and justice. [Extracted from the article]

Introduction: At the beginning of the pandemic, studies showed a higher risk of severe surgical complications and mortality among patients with perioperative SARS-CoV-2 infection, which led to the suspension of elective surgery. Confinement and lockdown measures were shown to be associated with weight gain and less access to medical and surgical care in patients with obesity, with negative health consequences. To evaluate the safety of bariatric surgery during the pandemic, we compared 30-day complications between patients who underwent bariatric surgery immediately before with those who underwent bariatric surgery during the opening phase of the pandemic. Methods: Observational analytical study of a non-concurrent cohort of patients who underwent bariatric surgery in 2 periods: pre-pandemic March 1 to December 31, 2019, and pandemic March 1 to December 31, 2020. Surgical complications were defined using the Clavien-Dindo classification. Results: Pre-pandemic and pandemic groups included 256 and 202 patients who underwent primary bariatric surgery, respectively. The mean age was 37.6 + 10.3 years. The overall complication rate during the first 30 days of discharge was 7.42%. No differences between groups were observed in severe complications (pre-pandemic 1.56% vs. pandemic 1.98%, p: 0.58). No mortality was reported. Overall 30-day readmission was 3.28% with no differences between groups. Conclusion: The findings of this study did not find a difference in the rate of severe complications, nor also we report severe COVID-19 complications in this high-risk population. During the pandemic, with appropriately implemented protocol, the resumption of bariatric surgery is possible with no increased risk for patients. [ABSTRACT FROM AUTHOR]

Global warming and invasive species often act synergistically to threat native communities. The Neotropical Poeciliidae have extensively been introduced to control populations of malaria-transmitting mosquitoes and are now successful invaders around the world. Poecilids introduced to a habitat in the fringe of its thermal tolerance will be increasingly more competitive as temperature increases. This can lead to either local extinction or rapid adaptation of native species. We evaluated if the introduction of two-spot livebearers (Pseudoxiphophorus bimaculatus) has led, after approximately 28 years, to hereditary differences between amarillo fish (Girardinichthys multiradiatus) from an invaded and a non-invaded adjacent temperate mountain lake. Laboratory-born F1 amarillo from the two lakes were raised in either presence or absence of feeding competition with two-spot livebearers. F1 females from Zempoala foraged for shorter periods and were more frequently aggressive than those from Tonatiahua, whereas Zempoala males were quicker to start foraging, did so for shorter periods, and were less likely to fight with their own, than males from Tonatiahua. Similarly, amongst fish from Zempoala reared in the presence of competition with P. bimaculatus, females were slower to start foraging and foraged for shorter periods, and males had reduced foraging and agonistic behaviour, than those reared facing only conspecific competition. We conclude that temperature-dependent behavioural differences have arisen between populations of a native fish, seemingly linked to foraging in a competitive environment and the tendency to be aggressive towards conspecific and heterospecific fish. These differences are the result of both local adaptation and behavioural flexibility. [ABSTRACT FROM AUTHOR]

Graphite sheet (GS) electrodes are flexible and versatile substrates for sensing electrochemical; however, their use has been limited to incorporate (bio)chemical modifiers. Herein, we demonstrated that a cold (low temperature) CO2 plasma treatment of GS electrodes provides a substantial improvement of the electrochemical activity of these electrodes due to the increased structural defects on the GS surface as revealed by Raman spectroscopy (ID/IG ratio), and scanning electron microscopy images. XPS analyses confirmed the formation of oxygenated functional groups at the GS surface after the plasma treatment that are intrinsically related to the substantial increase in the electron transfer coefficient (K0 values increased from 1.46 × 10−6 to 2.09 × 10−3 cm s−1) and with reduction of the resistance to charge transfer (from 129.8 to 0.251 kΩ). The improved electrochemical activity of CO2-GS electrodes was checked for the detection of emerging contaminant species, such as chloramphenicol (CHL), ciprofloxacin (CIP) and sulphanilamide (SUL) antibiotics, at around + 0.15, + 1.10 and + 0.85 V (versus Ag/AgCl), respectively, by square wave voltammetry. Limit of detection values in the submicromolar range were achieved for CHL (0.08 μmol L−1), CIP (0.01 μmol L−1) and SFL (0.11 μmol L−1), which enabled the sensor to be successfully applied to natural waters and urine samples (recovery values from 85 to 119%). The CO2-GS electrode is highly stable and inexpensive ($0.09 each sensor) and can be easily inserted in portable 3D printed cells for environmental on-site analyses. [ABSTRACT FROM AUTHOR]

Despite local efforts to replace wood as the main energy source and alleviate the health consequences of their emissions, in most Chilean cities below the 36° S, parallel wood is the main fuel source for home heating and cooking. Valdivia is a city located in the Chilean southern macro-zone where limited research has been carried out to characterize seasonal and daily behavior of atmospheric particulate matter (PM) levels and the potential effects that local PM have over human lung cells. To characterize Valdivia's ambient PM levels, we assessed daily and hourly PM10 and PM2.5 concentration records in two sampling stations managed by the Chilean Ministry of Environment (VAL-1 and VAL-2). Also, we collected PM2.5 samples from these sites and exposed human lung epithelial cells to assess Valdivia's PM2.5 effects over lung cell viability. PM10 and PM2.5 daily levels showed a strong seasonality dependance (cold period [April–September] > warm period [October–March]) and for the years with available data (VAL-1 [2008–2021], VAL-2 [2018–2021]), an average trend of reduction was found (0.5–1.6 μg/m3 by year). VAL-1 PM levels surpassed those measured at VAL-2 (cold period > warm period) and surpassed the levels stablished by national standards and recommended by the World Health Organization (WHO). Hourly PM levels showed a minor peak in the morning (~6–10) and a robust one at night (~18–3). Weekly PM2.5 ambient samples collected at VAL-1 and VAL-2 were exposed to human lung epithelial cells (A549 and Calu-1) to assess their relative cytotoxicity (cell viability). These samples were compared with standard particulate samples from diesel exhaust (C-DEP), volcanic ashes (MSH), residual oil fly ash (ROFA), and other urban ambient site (Ottawa Dust) through a dose response (ranging 0–100 μg/mL) at 0, 24, 48, and 72 h of exposure. C-DEP and MSH induced a modest reduction in viability (MSH > C-DEP) that was surpassed by VAL-1, VAL-2, and Ottawa Dust which in turn was surpassed by ROFA. Generally, Calu-1 cells and A549 cells were similarly sensitive to ROFA while the A549 cells were more sensitive to ambient samples. Taken together, these results show that PM concentration differences between sites located in Valdivia city present annual and daily peaks consistent with massive wood usage and that ambient PM2.5 samples induced significant cell viability reductions comparable with standard ambient samples. [ABSTRACT FROM AUTHOR]

Despite campaigns and improvements in detection and treatment, lung cancer continues to increase worldwide and represents a major public health problem. One approach to treating patients suffering from lung cancer is to target surface receptors overexpressed on tumor cells, such as GPCR-family kinin receptors, and proteases that control tumor progression, such as kallikrein-related peptidases (KLKs). These proteases have been visualized in recent years due to their contribution to the progression of cancers, such as prostate and ovarian cancer, facilitating the invasive and metastatic capacity of tumor cells in these tissues. In fact, KLK3 is the specific prostate antigen, the only tissue-specific biomarker used to diagnose this malignancy. In lung cancer to date, evidence indicates that KLK5, KLK6, KLK8, KLK11, and KLK14 are the major peptidases regulated and involved in its progression. The expression levels of KLKs in this neoplasm are modulated by the secretome of the different cell types present in the tumor microenvironment, the cancer subtype and the tumor stage, among others. Considering the multiple functions of kinin receptors and KLKs, this review highlights their roles, even considering the SARS-CoV-2 effects. Since lung cancer is often diagnosed in advanced stages, our efforts should focus on early diagnosis, validating for example specific KLKs, especially in high-risk populations such as smokers and people exposed to carcinogenic fumes, oil fields, and contaminated workplaces, unexplored fields to investigate. Furthermore, their modulation could be considered as a promising approach in lung cancer therapeutics. [ABSTRACT FROM AUTHOR]

A new electrochemical device fabricated by the combination of 3D printing manufacturing and laser-generated graphene sensors is presented. Cell and electrodes were 3D printed by the fused deposition modeling (FDM) technique employing acrylonitrile butadiene styrene filament (insulating material that composes the cell) and conductive filament (lab-made filament based on graphite dispersed into polylactic acid matrix) to obtain reference and auxiliary electrodes. Infrared-laser engraved graphene, also reported as laser-induced graphene (LIG), was produced by laser conversion of a polyimide substrate, which was assembled in the 3D-printed electrochemical cell that enables the analysis of low volumes (50–2000 μL). XPS analysis revealed the formation of nitrogen-doped graphene multilayers that resulted in excellent electrochemical sensing properties toward the detection of atropine (ATR), a substance that was found in beverages to facilitate sexual assault and other criminal acts. Linear range between 5 and 35 μmol L−1, detection limit of 1 μmol L−1, and adequate precision (RSD = 4.7%, n = 10) were achieved using differential-pulse voltammetry. The method was successfully applied to beverage samples with recovery values ranging from 80 to 105%. Interference studies in the presence of species commonly found in beverages confirmed satisfactory selectivity for ATR sensing. The devices proposed are useful portable analytical tools for on-site applications in the forensic scenario. [ABSTRACT FROM AUTHOR]

Lameness is a common condition in dairy cattle caused by infectious or noninfectious agents. Joint lesions are the second most common cause of lameness and can be diagnosed in association with the presentation of digit injuries. Fibroblast-like synoviocyte (FLS) are predominant cells of synovia and play a key role in the pathophysiology of joint diseases, thus increasing the expression of proinflammatory mediators. Tumor necrosis factor-alpha (TNF-α) is a potent proinflammatory cytokine involved in cyclooxygenase 2 (COX-2) and proinflammatory cytokine expression in FLS. Previously, TNF-α was demonstrated to increase hypoxia-inducible Factor 1 (HIF-1), a transcription factor that rewires cellular metabolism and increases the expression of interleukin (IL)-6 in bovine FLS (bFLS). Despite this, the proinflammatory effects of TNF-α in bFLS on metabolic reprogramming have been poorly studied. We hypothesized that TNF-α increases glycolysis and in this way controls the expression of IL-6, IL-8, and COX-2 in bFLS. Results first, gas chromatography/mass spectrometry (GC/MS)-based untargeted metabolomics revealed that bTNF-α altered the metabolism of bFLS, increasing glucose, isoleucine, leucine, methionine, valine, tyrosine, and lysine and decreasing malate, fumarate, α-ketoglutarate, stearate, palmitate, laurate, aspartate, and alanine. In addition, metabolic flux analysis using D-glucose-13C6 demonstrated an increase of pyruvate and a reduction in malate and citrate levels, suggesting a decreased flux toward the tricarboxylic acid cycle after bTNF-α stimulation. However, bTNF-α increased lactate dehydrogenase subunit A (LDHA), IL-6, IL-8, IL-1β and COX-2 expression, which was dependent on glycolysis and the PI3K/Akt pathway. The use of FX11 and dichloroacetate (DCA), an inhibitor of LDHA and pyruvate dehydrogenase kinase (PDK) respectively, partially reduced the expression of IL-6. Our results suggest that bTNF-α induces metabolic reprogramming that favors glycolysis in bFLS and increases IL-6, IL-8, IL-1β and COX-2/PGE2. [ABSTRACT FROM AUTHOR]

The combination of CO2 laser ablation and electrochemical surface treatments is demonstrated to improve the electrochemical performance of carbon black/polylactic acid (CB/PLA) 3D-printed electrodes through the growth of flower-like Na2O nanostructures on their surface. Scanning electron microscopy images revealed that the combination of treatments ablated the electrode's polymeric layer, exposing a porous surface where Na2O flower-like nanostructures were formed. The electrochemical performance of the fabricated electrodes was measured by the reversibility of the ferri/ferrocyanide redox couple presenting a significantly improved performance compared with electrodes treated by only one of the steps. Electrodes treated by the combined method also showed a better electrochemical response for tyrosine oxidation. These electrodes were used as a non-enzymatic tyrosine sensor for quantification in human urine samples. Two fortified urine samples were analyzed, and the recovery values were 106 and 109%. The LOD and LOQ for tyrosine determination were 0.25 and 0.83 μmol L−1, respectively, demonstrating that the proposed devices are suitable sensors for analyses of biological samples, even at low analyte concentrations. [ABSTRACT FROM AUTHOR]

Cellophane film production generates cellulosic residues from scraps, edges, and low-quality films. In this work, cellophane was used as a raw material to produce cellulose acetate (CA). CA was produced through the homogeneous route for 6 to 24 hours producing materials with a degree of substitution (DS) between 2.6 and 2.9. The CA materials were characterized by Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), X-ray diffraction (XRD), and viscosity-average molecular weight. DS values (DS > 2.6) indicate the preferential formation of cellulose triacetate, and the reaction time leads to materials with different molecular weight from 32,000 to 121,000 g mol - 1 The TGA and DSC curves allowed obtaining information that, together with other techniques, confirm the formation of cellulose triacetate and the production of a material with a heterogeneous structure. The CA membrane was prepared with CA produced with 14 hours of the reaction intended to control the release rates of acetaminophen (ACP). A dense, seemingly pore-free membrane has been produced, as seen by SEM images, which allows the release of small amounts of ACP. The results were promising in the development of CA membranes for the controlled release of drugs from the chemical modification of cellophane residues. [ABSTRACT FROM AUTHOR]

The first hours after birth entail a window of opportunity to decrease morbidity and mortality among extremely preterm infants. The availability of staff and its tiredness vary depending on the timing and day of the week. We hypothesized that these circumstances may impact neonatal outcomes. We have conducted a multicenter cohort study with data obtained from the Spanish neonatal network database SEN1500, where staff doctors are in the house 24/7. The main study exposure was the time of birth; secondary exposures were cumulative work hours from the medical and nurses' shifts and day of the week. The primary outcome was survival to hospital discharge. Secondary outcomes included common preterm infants' in-hospital complications. Univariate and multivariate analysis adjusting for potential confounders was performed. All extremely preterm infants (N = 8798) born between 2011 and 2019 were eligible; 35.7% of them were admitted during the night shift. No differences were found between day and night births regarding survival or morbidity. No differences were found between weekdays and weekends or when considering cumulative worked hours in the shifts. Infants born during the night shift were more likely to be intubated at birth (OR 1.20, CI95% 1.06–1.37), receive surfactant (OR 1.24, CI95% 1.08–1.44), and having anemia requiring transfusion (OR 1.23, CI 95% 1.08–1.42). Conclusion: the time of birth did not seem to affect mortality and morbidity of extremely preterm infants. What is Known: • The first hours after birth in extremely preterm infants are a very valuable opportunity to decrease mortality and morbidity. • Time and day of birth have long been linked to outcomes in preterm infants, with night shifts and weekends classically having higher rates of mortality and morbidity. What is New: • In this study, no differences were found between day and night births regarding survival or major morbidity. • Infants born during the night shift were more likely to be intubated at birth, receive surfactant and having anemia requiring transfusion. [ABSTRACT FROM AUTHOR]

Graphene-based materials present unique properties for electrochemical applications, and laser-induced conversion of polyimide to graphene is an emerging route to obtain a high-quality material for sensing. Herein we present compact and low-cost equipment constructed from an open-source 3D printer at which a 3.5-W visible (449 nm) laser was adapted to fabricate laser-induced graphene (LIG) electrodes from commercial polyimide, which resulted in electron transfer kinetic (k0) of 5.6 × 10−3 cm s−1 and reproducibility calculated by relative standard deviation (RSD < 5%) from cyclic voltammograms of [Fe(CN)6]3−/4− using 5 different electrodes. LIG electrodes enabled the simultaneous voltammetric determination of uric acid (+ 0.1 V vs. pseudo-reference) and nitrite (+ 0.4 V vs pseudo-reference), with limit of detection (LOD) values of 0.07 and 0.27 µmol L−1, respectively. Amperometric measurements for the detection of H2O2 (applying + 0.0 V vs. Ag|AgCl|KCl(sat.)) after Prussian blue (PB) modification and ciprofloxacin (applying + 1.2 V vs. Ag|AgCl|KCl(sat.)) were performed under flow conditions, which confirmed the high stability of LIG and LIG-PB surfaces. The LOD values were 1.0 and 0.2 µmol L−1 for H2O2 and ciprofloxacin, respectively. The RSD values (< 12%) obtained for the analysis using three different electrodes attested the precision of LIG electrodes manufactured in two designs. No sample matrix effects on the determination of ciprofloxacin in milk samples were observed (recoveries between 84 and 96%). The equipment can be built with less than $300 and each LIG electrode costs less than $0.01. [ABSTRACT FROM AUTHOR]

A laser-induced graphene (LIG) surface modified with Prussian blue (iron hexacyanoferrate) is demonstrated as a novel electrochemical sensing platform for the sensitive and selective detection of hydrogen peroxide. Electrochemical Prussian blue (PB) modification on porous graphene films engraved by infrared laser over flexible polyimide was accomplished. Scanning electron microscopy images combined with Raman spectra confirm the formation of porous graphene and homogenous electrodeposition of PB over this porous surface. Electrochemical impedance spectroscopy reveals a substantial decrease in the resistance to charge transfer values (from 395 to 31.4 Ω) after the PB insertion, which confirms the formation of a highly conductive PB-graphene composite. The synergistic properties of PB and porous graphene were investigated for the constant monitoring of hydrogen peroxide at 0.0 V vs. Ag|AgCl|KCl(sat.), under high-flow injections (166 µL s−1) confirming the high stability of the modified surface and fast response within a wide linear range (from 1 to 200 µmol L−1). Satisfactory detection limit (0.26 µmol L−1) and selectivity verified by the analysis of complex samples confirmed the excellent sensing performance of this platform. We highlight that the outstanding sensing characteristics of the developed sensor were superior in comparison with other PB-based or LIG-based electrochemical sensors reported for hydrogen peroxide detection. [ABSTRACT FROM AUTHOR]

Low oxidation stability is the main drawback of biodiesels and biokerosenes that is overcome by using antioxidants, which can be combined due to synergistic effects. This paper demonstrates that 3D-printed electrochemical devices can be applied to biofuel electroanalysis, including the monitoring of oxidation stability by quantifying the antioxidant content in biofuels. Fabrication requires 3D-printed acrylic templates at which a polylactic acid (PLA) filament with conducting carbon-black filling sensors is extruded by a 3D pen. The antioxidants butyl hydroxyanisole (BHA) and tert-butylhydroquinone (TBHQ) are the most employed additives in biodiesel production, and thus, their electrochemical behavior was investigated; 2,6-ditertbutylphenol (2,6-DTBP) was included in this investigation because it is commonly added to biokerosenes. The electrochemical surface treatment of the 3D-printed electrodes improved the current responses of all antioxidants; however, the electrochemical oxidation of TBHQ was clearly more affected by an electrocatalytic action shifting its oxidation towards less positive potentials (~200 mV), which resulted in a better separation of TBHQ and BHA oxidation peaks (+0.4 and +0.6 V vs Ag|AgCl, respectively). The oxidation of 2,6-DTBP occurred at more positive potentials (+1.2 V vs Ag|AgCl). The simultaneous determination of TBHQ and BHA by differential-pulse voltammetry resulted in linear responses in the range 0.5 and 175 μmol L−1 with limits of detection and quantification of 0.15 μmol L−1 and 0.5 μmol L−1, respectively. The presence of Fe3+, Cu2+, Pb2+, Mn2+, Cd2+, and Zn2+, even in high concentrations, did not interfere in the determination of TBHQ and BHA. The determination of 2,6-DTBP in biokerosene was achieved by cyclic voltammetry. All relative standard deviations (RSD) were lower than 6.0 %, indicating adequate precision of the methods. Spiked biofuel samples were analyzed (after dilution in electrolyte) and recovery values between 85 and 120% were obtained, which indicates absence of sample matrix effects. [ABSTRACT FROM AUTHOR]

Background and aims: EUS-guided choledochoduodenostomy (EUS-CDS) is an effective option for biliary drainage in malignant biliary obstruction. Lumen apposing metal stents (LAMS) are increasingly been used for EUS-CDS. It is unknown how LAMS compare to tubular self-expandable metal stents (SEMS) for EUS-CDS. Our aim is to compare the clinical outcomes of LAMS versus SEMS for EUS-CDS. Patients and methods: Single-center retrospective cohort study of consecutive patients with unresectable malignant biliary obstruction who underwent EUS-CDS after failed ERCP for initial biliary drainage between 2011 and 2019. Clinical outcomes were compared between patients who had conventional covered SEMS and LAMS placed for EUS-CDS. Outcome measures included unplanned procedural events, technical success, clinical success, adverse events and reinterventions. Survival was analyzed by the Kaplan–Meier method. Results: During the study period 57 patients met inclusion criteria (37 LAMS, 20 SEMS). All EUS-CDS were technically successful (LAMS group 95% CI 90.3–100%, SEMS group 95% CI 83.2–100%). There were no differences between groups in unplanned procedural events (4 LAMS deployment issues, 2 mild bleeding in SEMS group; 10 vs 10.8%), clinical success (37/37 [100%] vs 19/20 [95%]), and short-term adverse events (5/37 [13.5%] vs 4/20 [20%], p = 0.71). Complete follow-up data were available in 41 patients for a mean of 376 ± 145 days. Endoscopic reintervention was required for duodenal stent placement (n = 9) or biliary stent dysfunction (n = 4), with no difference between LAMS and SEMS group (6/37 [16.2%] vs 7/20 [35%]). There were no differences in overall survival between both groups. Conclusions: EUS-guided choledochoduodenostomy after failed ERCP has equally high technical and clinical success rates with either LAMS or SEMS in patients with malignant biliary obstruction. No differences in adverse events, reinterventions and survival were seen with either type of stent. The cost-effectiveness of LAMS vs SEMS for EUS-guided choledochoduodenostomy remains to be proven. [ABSTRACT FROM AUTHOR]

Recent coronavirus outbreak and "stay at home" policies have accelerated the implementation of virtual healthcare. Many surgery departments are implementing telemedicine to enhance remote perioperative care. However, concern still arises regarding the safety of this modality in postoperative follow-up after gastrointestinal surgery. The aim of the present prospective study is to compare the use of telemedicine clinics to in-person follow-up for postoperative care after gastrointestinal surgery during COVID-19 outbreak.Methods: Prospective study that included all abdominal surgery patients operated since the COVID-19 outbreak. On discharge, patients were given the option to perform their postoperative follow-up appointment by telemedicine or by in-person clinics. Demographic, perioperative, and follow-up variables were analyzed.Results: Among 219 patients who underwent abdominal surgery, 106 (48%) had their postoperative follow-up using telemedicine. There were no differences in age, gender, ASA score, and COVID-19 positive rate between groups. Patients who preferred telemedicine over in-person follow-up were more likely to have undergone laparoscopic surgery (71% vs. 51%, P = 0.037) and emergency surgery (55% vs. 41%; P = 0.038). Morbidity rate for telemedicine and in-person group was 5.7% and 8%, (P = 0.50). Only 2.8% of patients needed an in-person visit following the telemedicine consult, and 1.9% visited the emergency department.Conclusions: In the current pandemic, telemedicine follow-up can be safely and effectively performed in selected surgical patients. Patients who underwent laparoscopic and emergency procedures opted more for telemedicine than in-person follow-up. [ABSTRACT FROM AUTHOR]

For the first time the development of an electrochemical method for simultaneous quantification of Zn2+ and uric acid (UA) in sweat is described using an electrochemically treated 3D-printed working electrode. Sweat analysis can provide important information about metabolites that are valuable indicators of biological processes. Improved performance of the 3D-printed electrode was achieved after electrochemical treatment of its surface in an alkaline medium. This treatment promotes the PLA removal (insulating layer) and exposes carbon black (CB) conductive sites. The pH and the square-wave anodic stripping voltammetry technique were carefully adjusted to optimize the method. The peaks for Zn2+ and UA were well-defined at around − 1.1 V and + 0.45 V (vs. CB/PLA pseudo-reference), respectively, using the treated surface under optimized conditions. The calibration curve showed a linear range of 1 to 70 µg L−1 and 1 to 70 µmol L−1 for Zn2+ and UA, respectively. Relative standard deviation values were estimated as 4.8% (n = 10, 30 µg L−1) and 6.1% (n = 10, 30 µmol L−1) for Zn2+ and UA, respectively. The detection limits for Zn2+ and UA were 0.10 µg L−1 and 0.28 µmol L−1, respectively. Both species were determined simultaneously in real sweat samples, and the achieved recovery percentages were between 95 and 106% for Zn2+ and 82 and 108% for UA. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to describe the incidence, associated factors, etiology, and management of small bowel obstructions following laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods: A retrospective analysis was conducted between January 15 and December 19 using the surgery database of our hospital. Included LRYGB patients were those that evolved with a prolonged length of stay; readmission; emergency room consult; and re-intervention due to small bowel obstruction (SBO) related symptoms with compatible radiological or intraoperative findings. The LRYGB technique implied an antecolic alimentary limb reconstruction and systematic closure of mesenteric defects. Descriptive and analytical statistics were carried out, using a parametric or non-parametric approach as needed. Results: Nine hundred forty-one LRYGB were performed. 9.9% were revisional surgeries of patients with a laparoscopic sleeve gastrectomy. During the study period, 36 SBOs occurred, representing 3.8% of operated patients, with no mortality. 58.3% had successful non-operative management, while 41.7% required surgical exploration, of which 73.3% were treated laparoscopically and 20% needed conversion to open surgery. Etiologies of SBO were jejuno-jejunostomy (JJO) related stenosis (22, 61.1%), internal hernias (6, 16.7%), adherences (3, 8.3%), and other diagnoses (5, 13.9%). Regarding JJO stenosis and internal hernias, median time to diagnosis was 8 days (IQR 7–11) and 12 months (IQR 8.7–16) respectively. Previous sleeve gastrectomy, age, or sex was not associated to the incidence of small bowel obstruction. Conclusions: LRYGB is safe when performed by experienced surgeons. SBO due to internal hernias were scarce in this series. JJO stenosis could explain most cases of SBO; under this diagnosis, non-surgical management was successful frequently. [ABSTRACT FROM AUTHOR]

Keywords: Bariatric surgery; Sleeve gastrectomy; Gastric cancer EN Bariatric surgery Sleeve gastrectomy Gastric cancer 2797 2800 4 05/13/21 20210601 NES 210601 Introduction The number of bariatric surgeries performed worldwide over the last decades has increased. These tumors are particularly relevant in our country since Chile has an intermediate risk for gastric cancer (GC) development, as shown by an age-standardized incidence rate (ASIR) of GC mortality of 10-20/100.000 inhabitants [[6]]. Discussion Although the number of patients with GC after BS remains low, there has been a constant increase in the number of publications over the last years; specifically, to this date, there have been six patients with GC after SG [[9]-[12], [14], [17]]. For instance, when we analyzed preoperative UGE findings in 626 patients before surgery, 46% were abnormal, and we found only one patient with an early GC [[7]]. [Extracted from the article]

Introduction: Laparoscopic bariatric surgery (LBS) in liver end-stage organ disease has been proven to improve organ function and patients' symptoms. A series of LBS in patients with cirrhosis have shown good results in weight loss, but increased risk of complications. Current literature is based on clinical series. This paper aims to compare LBS (69% gastric bypass) between patients with cirrhosis and without cirrhosis. Methods: We conducted a retrospective 1:3 matched case-control study including bariatric patients with cirrhosis and without cirrhosis. Demographics, operative variables, postoperative complications, long-term weight loss, and comorbidity resolution were compared between groups. Results: Sixteen Child A patients were included in the patients with cirrhosis (PC) group and 48 in patients without cirrhosis (control) group. Mean age was 50 years; preoperative BMI was 39 ± 6.8 kg/m2. Laparoscopic gastric bypass and laparoscopic sleeve gastrectomy were performed in 69% and 31%, respectively. Follow-up was 81% at 2 years for both groups. PC group had a higher rate of overall (31% vs. 6%; p < 0.05) and severe (Clavien-Dindo ≥ III; 13% vs. 0%; p = 0.013) complications than that of the control group. Mean %EWL of PC at 2 years of follow-up was 84.9%, without differences compared with that of the control group (83.1%). Comorbidity remission in PC was 14%, 50%, and 85% for hypertension, type 2 diabetes, and dyslipidemia, respectively. Patients without cirrhosis had a higher resolution rate of hypertension (65% vs. 14%, p = 0.03). Conclusion: LBS is effective for weight loss and comorbidity resolution in patients with obesity and Child A liver cirrhosis. However, these results are accompanied by significantly increased risk of complications. [ABSTRACT FROM AUTHOR]

In this paper, we compare reduced graphene oxide (RGO) electrode with multi-walled carbon nanotubes (MWCNT) as modifiers for the sensitive detection of levofloxacin. The RGO-based sensor showed higher currents for levofloxacin compared with the MWCNT-modified (4-fold) and unmodified electrodes (20-fold). A thin-layer adsorptive process was verified for the oxidation of levofloxacin on the RGO-modified electrode which explains the higher currents. Differential pulse voltammetry (DPV), square wave voltammetry (SWV), and amperometric detection using flow-injection analysis (FIA-AMP) were evaluated for levofloxacin determination in urine and pharmaceutical samples. Detection limits of 1.45, 6.70, and 1.90 μmol L−1 and recovery levels of 91, 106, and 103%, respectively were obtained. A relative standard deviation lower than 7.7% indicated proper precision. The FIA-AMP using the RGO-modified electrode presented high analytical frequency (around 100 injections per hour) and thus was selected for the analysis of the samples. Statistically, similar results (95% confidence level) compared with ultra-fast liquid chromatography (UFLC) analysis and recovery level of 96% for the analysis of urine were obtained. [ABSTRACT FROM AUTHOR]

We show that fused deposition modelling (FDM) 3D-printed electrodes can be used for quality control of fuel bioethanol. 3D-printing using carbon black/polylactic acid (CB-PLA) filaments resulted in conductive and biodegradable electrodes for biofuel analysis. As a proof-of-concept, copper determination in fuel bioethanol was performed, as such ions catalyse oxidation processes during storage and transport. Square-wave anodic-stripping voltammetry (SWASV) of copper was achieved after sample dilution in 0.1 mol L−1 HCl as supporting electrolyte (resulting in 30:70% v/v ethanol:water). The linear responses were in the range between 10 and 300 μg L−1 (R = 0.999), inter-day precision was lower than 8% (n = 10, for 20 μg L−1) and limits of detection (LOD) and quantification (LOQ) using 180 s as deposition time were 0.097 μg L−1 and 0.323 μg L−1, respectively. Recovery values between 95 and 103% for the analysis of bioethanol spiked with known amounts of copper were obtained. These results show great promise of the application of 3D-printed sensors for the quality control of biofuels. [ABSTRACT FROM AUTHOR]

Many studies have explored the links between music and children's outcomes; however, study designs have not been sufficiently rigorous to support causal findings. This study aims to assess the effects of a large-scale music program on children's developmental functioning in the context of high rates of exposure to violence. The paper describes the results of an experimental evaluation of Venezuela's National System of Youth and Children's Orchestras. The curriculum of the program, better known as "El Sistema," emphasizes social interactions through group instruction and group performances. The randomized control trial was conducted in 16 music centers between May 2012 and November 2013. In total, 2914 children ages 6-14 participated in the experiment, with approximately half receiving an offer of admission to the program in September 2012 and half in September 2013. The treatment group children participated for one semester more than the control group children. After 1 year, full-sample ITT estimates indicate improved self-control (by 0.10 standard deviations) and reduced behavioral difficulties (by 0.08 standard deviations), both significant at 10% after controlling for multiple hypothesis testing. There were no full-sample effects on other domains. Sub-sample effects are larger among (1) children with less-educated mothers and (2) boys, especially those exposed to violence at baseline. In the latter subgroup, we find lower levels of aggressive behavior. We find that the program improved self-control and reduced behavioral difficulties, with the effects concentrated among subgroups of vulnerable children. The results suggest the importance of devising mechanisms to target resources to the most vulnerable children.Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02369315. [ABSTRACT FROM AUTHOR]

Floods in cities are increasingly common as a consequence of multifactor watershed dynamics, including geomorphology, land-use changes and land subsidence. However, urban managers have focused on infrastructure to address floods by reducing blocked sewage infrastructure, without significant success. Using Mexico City as a case study, we generated a spatial flood risk model with geomorphology and anthropogenic variables. The results helped contrast the implications of different public policies in land use and waste disposal, and correlating them with flood hazards. Waste disposal was only related to small floods. 58% of the city has a high risk of experiencing small floods, and 24% of the city has a risk for large floods. Half of the population with the lowest income is located in the high-risk areas for large floods. These models are easy to build, generate fast results and are able to help to flood policies, by understanding flood interactions in urban areas within the watershed. [ABSTRACT FROM AUTHOR]

Background: The duodenal-jejunal bypass liner (DJBL) is an endoscopic device that mimics the duodenal-jejunal exclusion component of the Roux-en-Y gastric bypass. Previous studies assessing the efficacy of the DJBL have shown 10-40% excess weight loss (%EWL) and improvements in obesity-associated comorbidities. The aim of this study was to evaluate the safety and efficacy of a new DJBL prototype over a 3-year period.Methods: Morbidly obese subjects were enrolled in a single-arm, open-label, prospective trial. The subjects were offered the opportunity to continue with the trial annually and signed a new consent form. The primary endpoint was safety. The secondary endpoints were changes in weight and biochemical parameters from baseline.Results: The DJBL was implanted endoscopically in 80 subjects (age: 35±10 years; 69% female; weight: 109±17 kg; BMI: 42±5.4 kg/m2). Seventy-two severe adverse events (AEs) were observed in 55 patients (68%), of which nine subjects required a prolonged hospital stay and three subjects required major interventions. Overall, 23 subjects (29%) underwent early device removal due to AEs. Additionally, 95% of the patients experienced mild AEs that mainly consisted of abdominal pain. The severe AEs included a liver abscess (3), upper GI bleeding (4), cholangitis (1), and acute pancreatitis (1) and mostly occurred after 12 months of follow-up. Two patients presented a short esophageal perforation during explantation. These perforations were successfully managed with endoscopic closure in one subject and medical treatment in the other subject. In the completer population at 52 weeks (71 patients), 104 weeks (40 patients), and 156 weeks (11 patients), the mean %EWL were 44 ± 16, 40 ± 22, and 39 ± 20, respectively (p < 0.001).Conclusion: This study shows significant and sustained weight loss after 3 years of treatment with the new DJBL. However, the high frequency and severity of AEs preclude the use of this prototype for periods longer than 1 year. [ABSTRACT FROM AUTHOR]

This work proposes the use of eucalyptus pulp as an adsorbent for biodiesel purification. Methyl sunflower biodiesel was produced by alkaline transesterification and passed through a column containing the adsorbent. The evaluated impurities were free glycerol, methanol, water content and alkali metals (Na, K, Ca and Mg). The cellulose fibers were fractionated by sieving in three fractions (sieve pore sizes of 500, 600 and 1,180 μm). The pulp was characterized by infrared, x-ray diffraction, viscosimetric molecular weight, water content, morphological analysis and fiber content of α-cellulose and hemicelluloses. The size of fibers, mass of adsorbent (0.2 and 1.0 g), column diameter (1.0 and 1.3 cm) and the aid of pressure for filtration (atmospheric or 18 psi) on the impurities removal were also evaluated. The physicochemical characterization of biodiesel was performed following tests in accordance with the limits set by the European Standard for oxidative stability at 110 °C, density at 20 °C, water content, acid value, free glycerol, kinematic viscosity at 40 °C, and residual methanol. The optimal condition was observed using 1.0 g of cellulose in a column of 1.3 cm in diameter under pressure of 18 psi was applied. In this condition the free glycerol, methanol and water content in the permeate presented values of 0.0081 ± 0.0001, 0.268 ± 0.009 % w/w and 636 mg kg, respectively. The results indicate that this cellulosic adsorbent is a promising material for biodiesel purification instead of using water washing, avoiding the generation of high wastewater volumes. [ABSTRACT FROM AUTHOR]

Introduction: Endoscopic treatment with the duodenal-jejunal bypass liner (DJBL) leads to significant weight loss in obese patients. We sought to identify clinical factors associated with weight loss in obese patients treated with the DJBL for 1 year. Methods: Subjects with morbid obesity were enrolled in a single-arm, open-label, prospective trial and implanted with the DJBL. Patient demographics along with baseline comorbidities, anthropometrics, and biochemical variables were selected for univariate and multivariate analysis. Results: The DJBL was implanted in 79 subjects and 61 completed 12 months of follow-up. There were 18 early removals. Baseline mean age and body mass index (BMI) were 35.4 ± 9.7 years and 43 ± 5.6 kg/m, respectively. Forty-four (72 %) were women. This population included 22 subjects with type 2 diabetes (T2DM). Twelve months after treatment, patients had a mean excess body weight loss (%EBWL) of 46 ± 18 %. Univariate analysis identified that fasting glycemia ( r = −0.303, p < 0.013), insulin-resistance determined by HOMA-IR ( r = −0.457, p < 0.019), and glycated hemoglobin (HbA1c) ( r = −0.471, p < 0.013) were associated inversely with %EBWL at 1 year. In this cohort of patients, the multivariate analysis indicated that only baseline HbA1c levels were associated inversely with %EBWL after 1 year of treatment ( β adjusted coefficient −0.758, p < 0.016). Importantly, no differences at 1 year in %EBWL were observed between patients with or without T2DM (%EBWL T2D 46.7 ± 20 % vs. non-T2DM 46.8 ± 18.6 %, p = 0.988). Conclusions: This analysis indicates that higher baseline HbA1c levels are associated independently with diminished body weight loss in obese patients treated with the DJBL independent of their diabetic status. These results show that DJBL induces clinically significant weight loss in both T2DM and non-T2DM patients. [ABSTRACT FROM AUTHOR]

Endoscopic placement of the duodenal-jejunal bypass liner (DJBL) in morbidly obese patients induces significant weight loss. Additionally, early studies reported significant improvements in several parameters of glucose homeostasis in morbidly obese patients with T2DM. The observed glycemic control occurred soon after device placement, after a minimal weight loss, suggesting the activation of weight loss-independent anti-diabetic mechanisms of glucose normalization. This effect is associated with favorable changes in hormones involved in glucose level regulation. Recently, larger clinical studies, focused primarily on the effect of the DJBL on T2DM treatment, have corroborated initial observations not only in morbidly obese patients but in non-morbidly obese diabetic patients as well. In this article we review the evidence from preclinical animal and clinical human studies that support the efficacy of DJBL to treat T2DM in obese patients. [ABSTRACT FROM AUTHOR]

Chronic Chagas' disease affects 10-30 % of patients infected with Trypanosoma cruzi, and it mainly manifests as cardiomyopathy. Important pathophysiological mechanisms involved in the cardiac lesions include activation of the endothelium and induced microvascular alterations. These processes involve the production of endothelial adhesion molecules and thromboxane A, which are involved in inflammatory cell recruitment and platelet aggregation, respectively. Cyclooxygenase inhibitors such as aspirin decrease thromboxane production and alter the course of Chagas' disease, both in the acute and chronic phases. We studied the effects of the administration of low and high doses of aspirin during the early phase of T. cruzi infection, following microvascular damage in the context of a chronic murine model of Chagas' disease. The effects of both schedules were assessed at 24 and 90 days postinfection by evaluating parasitemia, mortality, and cardiac histopathological changes as well as the expression of ICAM, VCAM, and E-selectin in cardiac tissue. Thromboxane A, soluble ICAM, and E-selectin blood levels were also measured. While aspirin did not affect parasitemia or mortality in the infected mice, it decreased both cardiac inflammatory infiltrates and thromboxane levels. Additionally, at 90 days postinfection, aspirin normalized sICAM and sE-selectin levels. Considering the improved endothelial function induced by aspirin, we propose the possibility of including this drug in clinical therapy to treat chronic Chagas' disease. [ABSTRACT FROM AUTHOR]

The efficacy of Roux-en-Y gastric bypass (RYGB) to control type 2 diabetes mellitus (T2DM) has been demonstrated in morbidly obese patients. Surgical procedures primarily focused on T2DM control in patients with body mass index (BMI) < 35 kg/m have shown to effectively induce remission of T2DM. However, only few reports have evaluated the safety and efficacy of RYGB in this group of patients. The aim of this study is to assess the safety and efficacy of RYGB in TD2M patients with BMI < 35 kg/m. All T2DM patients with BMI < 35 kg/m and at least 12 months of follow-up who underwent laparoscopic RYGB were included. Safety of the procedure was evaluated according to mortality, need of reoperation/conversion, and complication rates. Metabolic parameters were evaluated at baseline and 6, 12, and 24 months after surgery. Thirty patients were included. Seventeen (56.6%) were women. Age, BMI, and duration of diabetes were 48 ± 9 years, 33.7 ± 1.2 kg/m, 4 ± 2.9 years, respectively. No mortality was observed. No conversion/reoperation was needed. Average length of stay was 3.2 ± 0.9 days. Early and late postoperative complications were observed in five (16.6%) and five (16.6%) patients, respectively. Twelve months after surgery, remission was observed in 25 of 30 patients (83.3%). After 2 years, remission was achieved in 13 of 20 patients (65%), and hemoglobin A1c decreased from 8.1 ± 1.8% to 5.9 ± 1.1% and homeostasis model assessment of insulin resistance from 5.7 ± 3.2 to 1.9 ± 0.8 after 12 months. RYGB is a safe and effective procedure to induce T2DM remission in otherwise not eligible patients for bariatric surgery. Evidence from prospective studies is needed to validate this approach. [ABSTRACT FROM AUTHOR]

Bariatric surgery has evolved into multiple forms in the last decades, combining food restriction and malabsorption. The aim of this study was to develop a new technique based on food restriction and early stimulation of the distal gut, thus maintaining the alimentary tract continuity. Thirty-two Yorkshire pigs, weight 22.2 ± 5.4 kg (mean ± SD) were randomly assigned to four laparoscopic procedures: ileal transposition (IT, n = 8); sleeve gastrectomy with ileal transposition (SGIT, n = 8); Roux-en-Y gastric bypass (GBP, n = 8); sham operation (SHAM, n = 8). Firing 45-mm linear staplers over a 60-F bougie, resecting the greater curvature and fundus, constituted a sleeve gastrectomy. Ileal transposition was performed by isolating a 100-cm ileal segment proximal to the ileocecal valve and by dividing the proximal jejunum 15 cm distal to the ligament of Treitz and performing re-anastomosis. Gastric bypass consisted of creating a proximal gastric pouch and a 300 cm alimentary limb. Sham operation was performed by bowel transections and re-anastomosis in the ileum and proximal jejunum together with gastrotomy and closure. Animals were evaluated weekly for weight increase and food intake. We performed a logistic regression analysis to compare weight progression curves, and analysis of variance (ANOVA) and Bonferroni (Dunn) tests to detect differences in weight and food intake. We observed significant differences in mean weight after 18 weeks between SGIT (30.9 ± 13.4 kg) and SHAM (72.5 ± 10.7 kg) ( p = 0.0002), and GBP (28.6 ± 2.5 kg) and SHAM ( p = 0.0001), and IT (56.1 ± 13.4 kg) and SHAM ( p = 0.0081). No differences were observed between RYGB and SGIT. We also observed significant differences in food intake (grams per day) in the third month between SGIT (1668 ± 677 g) versus SHAM (3252 ± 476 g) ( p = 0.0006), and GBP (2011 ± 565 g) versus SHAM ( p = 0.039). No differences were observed in food intake between SGIT and GBP. SGIT proved to be as effective in the short term as GBP on weight progression with no bypass of the proximal gut. [ABSTRACT FROM AUTHOR]

Tropical forests are converted at an alarming rate for agricultural use and pastureland, but also regrow naturally through secondary succession. For successful forest restoration, it is essential to understand the mechanisms of secondary succession. These mechanisms may vary across forest types, but analyses across broad spatial scales are lacking. Here, we analyse forest recovery using 1,403 plots that differ in age since agricultural abandonment from 50 sites across the Neotropics. We analyse changes in community composition using species-specific stem wood density (WD), which is a key trait for plant growth, survival and forest carbon storage. In wet forest, succession proceeds from low towards high community WD (acquisitive towards conservative trait values), in line with standard successional theory. However, in dry forest, succession proceeds from high towards low community WD (conservative towards acquisitive trait values), probably because high WD reflects drought tolerance in harsh early successional environments. Dry season intensity drives WD recovery by influencing the start and trajectory of succession, resulting in convergence of the community WD over time as vegetation cover builds up. These ecological insights can be used to improve species selection for reforestation. Reforestation species selected to establish a first protective canopy layer should, among other criteria, ideally have a similar WD to the early successional communities that dominate under the prevailing macroclimatic conditions.

The nutrient demands of regrowing tropical forests are partly satisfied by nitrogen-fixing legume trees, but our understanding of the abundance of those species is biased towards wet tropical regions. Here we show how the abundance of Leguminosae is affected by both recovery from disturbance and large-scale rainfall gradients through a synthesis of forest inventory plots from a network of 42 Neotropical forest chronosequences. During the first three decades of natural forest regeneration, legume basal area is twice as high in dry compared with wet secondary forests. The tremendous ecological success of legumes in recently disturbed, water-limited forests is likely to be related to both their reduced leaflet size and ability to fix N 2 , which together enhance legume drought tolerance and water-use efficiency. Earth system models should incorporate these large-scale successional and climatic patterns of legume dominance to provide more accurate estimates of the maximum potential for natural nitrogen fixation across tropical forests.