The Safety and Efficacy of Concurrent Laparoscopic Cholecystectomy during Minimally Invasive Roux-en-Y Gastric Bypass: A Systematic Review.

We conducted a systematic review to examine perioperative outcomes for adults undergoing minimally invasive Roux-en-Y gastric bypass (RYGB) with and without concurrent cholecystectomy (CCE). We reviewed the literature using OVID MEDLINE(R), Embase, Cochrane CENTRAL, Web of Science, and medRxiv and identified studies published between 1946 and May 2023. We identified a total of 2402 studies with 11 included in the final analysis (combined 149,356 patients). Studies suggested increased operative time associated with RYGB-CCE, with mixed results regarding length of stay and rates of bile duct injury. Presently available data is not robust enough to conclude whether minimally invasive RYGB with CCE harms or benefits patients compared to RYGB alone.

Widespread Megaripple Activity Across the North Polar Ergs of Mars.

The most expansive dune fields on Mars surround the northern polar cap where various aeolian bedform classes are modified by wind and ice. The morphology and dynamics of these ripples, intermediate-scale bedforms (termed megaripples and Transverse Aeolian Ridges [TARs]), and sand dunes reflect information regarding regional boundary conditions. We found that populations of polar megaripples and larger TARs are distinct in terms of their morphology, spatial distribution, and mobility. Whereas regionally restricted TARs appeared degraded and static in long-baseline observations, polar megaripples were not only widespread but migrating at relatively high rates (0.13 ± 0.03 m/Earth year) and possibly more active than other regions on Mars. This high level of activity is somewhat surprising since there is limited seasonality for aeolian transport due to surficial frost and ice during the latter half of the martian year. A comprehensive analysis of an Olympia Cavi dune field estimated that the advancement of megaripples, ripples, and dunes avalanches accounted for ~1%, ~10%, and ~100%, respectively, of the total aeolian system's sand fluxes. This included dark-toned ripples that migrated the average equivalent of 9.6 ± 6 m/yr over just 22 days in northern summer-unprecedented rates for Mars. While bedform transport rates are some of the highest yet reported on Mars, the sand flux contribution between the different bedforms does not substantially vary from equatorial sites with lower rates. Seasonal off-cap sublimation winds and summer-time polar storms are attributed as the cause for the elevated activity, rather than cryospheric processes.

Dune-Yardang Interactions in Becquerel Crater, Mars.

Isolated landscapes largely shaped by aeolian processes can occur on Earth, while the majority of Mars' recent history has been dominated by wind-driven activity. Resultantly, Martian landscapes often exhibit large-scale aeolian features, including yardang landforms carved from sedimentary-layered deposits. High-resolution orbital monitoring has revealed that persistent bedform activity is occurring with dune and ripple migration implying ongoing abrasion of the surface. However, little is known about the interaction between dunes and the topography surrounding them. Here we explore dune-yardang interactions in Becquerel crater in an effort to better understand local landscape evolution. Dunes there occur on the north and south sides of a 700 m tall sedimentary deposit, which displays numerous superposed yardangs. Dune and yardang orientations are congruent, suggesting that they both were formed under a predominantly northerly wind regime. Migration rates and sediment fluxes decrease as dunes approach the deposit and begin to increase again downwind of the deposit where the effect of topographic sheltering decreases. Estimated sand abrasion rates (16-40 µm yr-1) would yield a formation time of 1.8-4.5 Myr for the 70 m deep yardangs. This evidence for local aeolian abrasion also helps explain the young exposure ages of deposit surfaces, as estimated by the crater size-frequency distribution. Comparisons to terrestrial dune activity and yardang development begin to place constraints on yardang formation times for both Earth and Mars. These results provide insight into the complexities of sediment transport on uneven terrain and are compelling examples of contemporary aeolian-driven landscape evolution on Mars.