Technical Aspects of Using a Second Magnetic Grasper to Improve the Surgical Field in Single Port Revisional Bariatric Surgery.

BACKGROUND: The future of minimally invasive surgery in revisional surgery is experiencing changes with new equipment such as the magnetic assistance that can be used with single port devices in order to perform an incisionless surgery (Luengas R, Galindo J, Castro M, et al. Surg Obes Relat Dis. 2021;17(1):147-152). Magnetic assistance through an auxiliary grasper with two internal magnets serves beyond liver retraction in different steps of the surgery improving the surgical field by obtaining a better visualization and triangulation. PURPOSE: Expose the feasibility of using two internal magnetic graspers by single port performing a conversion surgery of sleeve gastrectomy (SG) to Roux-en-Y gastric bypass (RYGB). METHODS: A 36-year-old female patient underwent a SG in 2015 and consults in 2021 because of severe GERD with a 33-point GERD-HRQL score. She has preoperative evaluation for a conversion surgery from SG to RYGB. Using a single port device through the umbilicus, an additional 5 mm trocar was placed in the left side of the abdomen. Two internal magnets were introduced through the umbilicus, and they were controlled by two external magnets placed over the abdomen with an articulated arm. The first magnet was used for liver retraction and the second one to perform both anastomoses, close the intermesenteric and Petersen defect, acting as an auxiliary grasper. The ethical committee approval was obtained through an informed consent from the participant included in the study.

Oversewing staple line of the gastric remnant in gastric bypass reduces postoperative bleeding.

BACKGROUND: Roux-en-Y gastric bypass (RYGB) is a surgery with low rate complications. However, it is not exempt from them, and 1-6% suffer complications such as postoperative bleeding. Many intraoperative techniques have been evaluated to reduce postoperative bleeding, like the oversewing or reinforcement of the staple line. This study aims to evaluate the rate of postoperative bleeding in the oversewing of the staple line of the gastric remnant group versus the stapling only group. METHODS: This is a 2-center, case-control study. We randomly selected two groups who underwent RYGB or OAGB: group A (n = 225) with oversewing from 2019 to 2020 and group B (n = 225) with stapling only between the period of 2017-2018; both groups with similar demographic characteristics. RESULTS: The overall mean age was 37.39 ± 9.6 years and mean BMI was 41.59 ± 8.6 kg/m2; the postoperative bleeding rate was significantly lower (p < 0,05) in patients with oversewing of the staple line of the gastric remnant. Operative time was shorter for the stapling only group and the difference between the mean operative time was 10.6 min. CONCLUSIONS: Oversewing the staple line of the gastric remnant significantly reduces the incidence of postoperative bleeding regardless of BMI. Being a cost-effective technique compared to others available despite the increase in operating time.

Long-run convergence of ethnic skill differentials, revisited.

In my original study, "Long-Run Convergence of Ethnic Skill Differentials," I concluded that the ethnic differentials introduced by the Great Migration seemed to persist into the second and third generations. Alba, Lutz, and Vesselinov argue that my study contained a number of conceptual and data problems, and conclude that the correlation between the skills of the first and the third generations disappears when these problems are taken into account. My reanalysis of the Alba et al. data, however, documents a stronger link between the skills of the first and the third generations than suggested by those authors.

Immigration and welfare magnets.

"This paper investigates if the location choices made by immigrants when they arrive in the United States are influenced by the interstate dispersion in welfare benefits. Income-maximizing behavior implies that foreign-born welfare recipients unlike their native-born counterparts, may be clustered in the states that offer the highest benefits. The empirical analysis indicates that immigrant welfare recipients are indeed more heavily clustered in high-benefit states than the immigrants who do not receive welfare, or than natives. As a result, the welfare participation rate of immigrants is much more sensitive to changes in welfare benefits than that of natives."

How much do immigration and trade affect labor market outcomes?

"This paper provides new estimates of the impact of immigration and trade on the U.S. labor market.... We examine the relation between economic outcomes for native workers and immigrant flows to regional labor markets.... We...use the factor proportions approach to examine the contributions of immigration and trade to recent changes in U.S. educational wage differentials and attempt to provide a broader assessment of the impact of immigration on the incomes of U.S. natives." Comments and discussion by John DiNardo, John M. Abowd, and others are included (pp. 68-85).

The earnings of Mexican immigrants in the United States.

"This paper documents the trends in the earnings of Mexican immigrants during the 1970-1990 period. The empirical evidence indicates that there has been a decline in the relative wage of successive Mexican immigrant waves in the past three decades and that little wage convergence occurs between the typical Mexican immigrant and the typical native worker. The data also suggest that the increasing importance of Mexican immigration is partly responsible for the deterioration in relative skills observed in the aggregate immigrant population, but that there has also been a decline in relative skills even among non-Mexican immigrants."

Assimilation and changes in cohort quality revisited: what happened to immigrant earnings in the 1980s?

"This article uses the 1970, 1980, and 1990 Public Use Samples of the U.S. census to document what happened to immigrant earnings in the 1980s and to determine if pre-1980 immigrant flows reached earnings parity with natives. The relative entry wage of successive immigrant cohorts declined by 9% in the 1970s and by an additional 6% in the 1980s. Although the relative wage of immigrants grows by 10% during the first 2 decades after arrival, recent immigrants will earn 15%-20% less than natives throughout much of their working lives."

Immigrant skills and ethnic spillovers.

"This paper investigates the hypothesis that ethnicity has spillover effects on the human capital accumulation process. It extends previous research by documenting the extent to which the relative importance of parental inputs and ethnic spillovers in the intergenerational transmission of skills differs both within and across immigrant and U.S.-born ethnic groups. Using data drawn from the General Social Surveys, the study documents that the second and third generations (i.e., the children and grandchildren of immigrants) experience relatively more rapid economic advancement than do other generations, and that ethnic spillovers play a stronger role in households which are at the extremes of the skill distribution."

Control of larval Aedes aegypti (Diptera: Culicidae) by cyclopoid copepods in peridomestic breeding containers.

Mesocyclops longisetus (Thiébaud), Mesocyclops thermocyclopoides Harada, Mesocyclops venezolanus Dussart, and Macrocyclops albidus (Jurine) were tested for their effectiveness in controlling Aedes aegypti (L.) larvae in a variety of containers around homes in El Progreso, Honduras. All four cyclopoid species killed > 20 larvae per cyclopoid per d under container conditions. M. longisetus was most effective, not only because it was the most voracious predator, but also because it survived best in the containers. M. longisetus maintained long-term populations in 200-liter drums, tires, vases, and cement tanks (without drains), providing the cyclopoids were not dried or poured out. M. longisetus reduced third- and fourth-instar Ae. aegypti larvae by > 98% compared with control containers without cyclopoids. M. longisetus should be of practical value for community-based Ae. aegypti control if appropriate attention is directed to maintaining it in containers after introduction.

Juvenile turtles for mosquito control in water storage tanks.

Juvenile turtles, Trachemys scripta, provided highly effective control of mosquito larvae in cement tanks (pilas) where water was stored for household cleaning. When single turtles were introduced to tanks with histories of high mosquito production, nearly all turtles remained in good health and no mosquito larvae survived to the pupal stage. Families welcome turtles in their water storage containers in Honduras. Humane conditions for turtles can be assured by providing small quantities of table scraps to supplement their diet and by placing a small floating platform in the tank for basking. Although turtles can serve as alternate hosts for Salmonella, available evidence suggests that turtles in tanks should not be a source of human infection. Further confirmation that there is no Salmonella hazard should precede routine use of turtles for mosquito control.

The employment and wages of legalized immigrants.

"This article analyzes the employment and wages of recently legalized immigrants [in the United States] using the Legalization Application Processing System (LAPS) file, an administrative file based on the individual records of amnesty applicants, and draws comparisons with a sample of the foreign-born population from the Current Population Surveys of 1983, 1986 and 1988. Compared to the total foreign-born population, the legalized immigrant population differs in four important respects that bear on labor market position: 1) a younger age structure; 2) a less balanced gender composition; 3) a greater representation of Latin Americans; and 4) few years of U.S. residence. LAPS data reveal high rates of labor force participation among legalized immigrants, which exceeded the rates of the foreign-born population by approximately 5 and 17 percent for men and women, respectively."

Self-selection and internal migration in the United States.

"Within the conceptual framework of the Roy model, this paper provides an empirical analysis of internal migration flows [in the United States] using data from the National Longitudinal Survey of Youth. The theoretical approach highlights regional differences in the returns to skills: regions that pay higher returns to skills attract more skilled workers than regions that pay lower returns. Our empirical results suggest that interstate differences in the returns to skills are a major determinant of both the size and skill composition of internal migration flows. Persons whose skills are most mismatched with the reward structure offered by their current state of residence are the persons most likely to leave that state, and these persons tend to relocate in states which offer higher rewards for their particular skills."

Economic theory and international migration.

The modern literature on the economics of immigration focuses on 3 related issues: 1) what determines the size and skill composition of immigrants flows to any particular host country; 2) how do the immigrants adapt to the host country's economy; and 3) what is the impact of immigrants on the host country's economy? This article reviews the theoretical framework and empirical evidence provided by the economics literature on these questions. It demonstrates that the economic approach, using the assumption that migration behavior is guided by the search for better economic opportunities and that the exchanges among the various players are regulated by an immigration market, leads to substantial insights in to these issues.

The economic consequences of immigration.

Available research supports several major conclusions about the economic consequences of immigration. (i) The aggregate impacts of foreign workers on the earnings and employment of native workers are quite small, but differ for selected population subgroups and high ethnic density labor markets. (ii) Immigrants who arrived during the 1970s are less skilled than earlier arrivals, and their earnings will remain substantially below those of natives throughout their working lives. (iii) The evidence on immigrants' receipt of public assistance income is inconclusive.

The labor supply of male Hispanic immigrants in the United States.

"Several recent studies have begun the systematic analysis of the labor market characteristics of Hispanics in the United States. This research has focused on two related issues: a) how the immigration and assimilation experience affects Hispanic earnings; and b) the measurement of wage differentials between Hispanics and non-Hispanics. The main findings of this research are that the earnings of (some) Hispanic immigrants rise rapidly after immigration; and that the wage differential between Hispanics and non-Hispanic whites is generally due to differences in observable skill characteristics. This article extends previous research by focusing on another labor market characteristic: the labor supply of Hispanic immigrants."