Smoking status predicts anastomotic leak after esophagectomy: a systematic review & meta-analysis.

BACKGROUND: Anastomotic leak after esophagectomy is a major contributor to surgery-related morbidity and mortality. The purpose of this systematic review was to evaluate if positive-smoking status is associated with the incidence of this complication. METHODS: A systematic search of MEDLINE, EMBASE, Scopus, Web of Science and Cochrane Library was performed on April 4th, 2023. Inclusion criteria comprised human participants undergoing esophagectomy, age ≥ 18, n ≥ 5, and identification of smoking status. The primary outcome was incidence of anastomotic leak. Sub-group analysis by ex- or current smoking status was performed. Meta-analysis was performed with RevMan 5.4.1 using a Mantel-Haenszel random-effects model. Publication bias was evaluated visually with funnel plots and through the Egger test. RESULTS: A total of 220 abstracts were screened, of which 69 full-text studies were assessed for eligibility, with 13 studies selected for final inclusion. This included 16,103 patients, of which 4433 were ex- or current smokers, and 9141 were never smokers. Meta-analysis revealed an increased odds of anastomotic leak in patients with a positive-smoking status (current or ex-smokers) compared to never smokers (OR 1.44, 95% CI 1.18-1.76, I2 = 44%, p < 0.001. Meta-analysis of six studies comparing active smokers alone to never smokers identified a significant increased odds of anastomotic leak (OR 1.80, 95% CI 1.25-2.59, p = 0.002, I2 = 0%). Meta-analysis of five studies comparing ex-smokers to never smokers identified a significant increased odds of anastomotic leak (OR 1.36, 95% CI 1.02-1.82, p = 0.04, I2 = 0%). The odds of anastomotic leak decreased among ex-smokers compared to active smokers. CONCLUSION: The findings of this systematic review and meta-analysis support the association between positive-smoking status and the risk of anastomotic leak after esophagectomy. Results further emphasize the importance of preoperative smoking cessation to reduce post-operative morbidity.

Does Behavior Evolve First? Correlated Responses to Selection for Voluntary Wheel-Running Behavior in House Mice.

AbstractHow traits at multiple levels of biological organization evolve in a correlated fashion in response to directional selection is poorly understood, but two popular models are the very general "behavior evolves first" (BEF) hypothesis and the more specific "morphology-performance-behavior-fitness" (MPBF) paradigm. Both acknowledge that selection often acts relatively directly on behavior and that when behavior evolves, other traits will as well but most with some lag. However, this proposition is exceedingly difficult to test in nature. Therefore, we studied correlated responses in the high-runner (HR) mouse selection experiment, in which four replicate lines have been bred for voluntary wheel-running behavior and compared with four nonselected control (C) lines. We analyzed a wide range of traits measured at generations 20-24 (with a focus on new data from generation 22), coinciding with the point at which all HR lines were reaching selection limits (plateaus). Significance levels (226 P values) were compared across trait types by ANOVA, and we used the positive false discovery rate to control for multiple comparisons. This meta-analysis showed that, surprisingly, the measures of performance (including maximal oxygen consumption during forced exercise) showed no evidence of having diverged between the HR and C lines, nor did any of the life history traits (e.g., litter size), whereas body mass had responded (decreased) at least as strongly as wheel running. Overall, results suggest that the HR lines of mice had evolved primarily by changes in motivation rather than performance ability at the time they were reaching selection limits. In addition, neither the BEF model nor the MPBF model of hierarchical evolution provides a particularly good fit to the HR mouse selection experiment.

Race and sex diversity in Canadian academic surgical societies.

BACKGROUND: It is vital for national professional surgical societies to embrace diversity, inclusion, and equity. This study examines race and sex diversity in two Canadian surgical societies. METHODS: Websites of the Canadian Society of Cardiac Surgeons (CSCS) and the Canadian Association of General Surgeons (CAGS) and previous programs of their annual meetings were reviewed. Leadership positions, conference speakers, and award winners were categorized by race and sex. RESULTS: White males made up the largest category of Cardiac Surgery meeting speakers (73/142 [51%]), CAGS committee members (89/198 [45%]), CAGS past presidents (38/43 [88%]), and General Surgery meeting speakers (841/1472 [57%]). Of the 17 members that made up the CSCS board of directors and officers, 8 were White males (47%), 5 were BIPOC males (29%), 3 were White females (18%), and 1 was a BIPOC female (6%). Of the 42 members of the CAGS board of directors and advisory committee, 16 were White males (38%), 5 were BIPOC males (12%), 17 were White females (40%), and 4 were BIPOC females (10%). CONCLUSIONS: BIPOC individuals and females are underrepresented in both societies compared to White males. However, in CAGS, improvements in representation can be seen in recent years. It is important that both of these organizations continue to embrace diversity.

Sex and racial diversity in Canadian academic surgery.

To ensure equitable representation of women and BIPOC (Black, Indigenous, person of colour) individuals in surgical specialties, it is first necessary to understand the presence and extent of the disparities that exist. We explored the websites of the 17 Canadian faculties of medicine to examine sex and racial diversity in surgical specialties and in surgical leadership positions in Canada. We categorized faculty members of each department of surgery as either male or female and White or BIPOC. The relative percentage of female academic surgeons was very low compared with Canadian demographic data, and the relative percentage of BIPOC academic surgeons was similar to Canadian demographic data. Our observations suggest that actions must be taken to improve diversity and inclusion in surgery.

Phytochemical Analysis and hypoglycemic potential of Filago hurdwarica (Wall. ex DC.) Wagenitz in alloxan induced diabetic mice.

Plants have profound therapeutic benefits, more economical treatments, fewer side effects, and a relatively cheap cost, making them a source of drugs for protective, preventative, curative, or conducive purposes and creating novel phytomedicines. Plant derived medicines are relatively safe compared to synthetic medicines. Many plants have proved to successfully aid in the treatment of diabetes including Filago hurdwarica (Wall. ex DC.) Wagenitz. The current investigations were therefore designed to assess the phytochemical, antioxidant, antidiabetic, and antihyperlipidemic activities of F. hurdwarica. The phytochemical investigations and antioxidant activities of different extracts were carried out using standard chemical tests, DPPH, and H2O2 scavenging assays. F. hurdwarica plant extract in Hydromethanolic solution were prepared by Soxhletation method and stored in refrigerator at 4°C for two days before use. Swiss Albino mice were made diabetic by a single dose of alloxan (150 mg/kg). Hydromethanolic plant extract and fractions of F. hurdwarica were screened for antidiabetic activity and given to the alloxan-induced diabetic mice at a concentration of 150-250 mg/kg of body weight in different groups of 6 diabetic mice each orally once a day for 15 days. Glibenclamide is also given to another group to as a standard drug to support the result at a dose of 10 mg/kg of body weight orally once a day for 15 days. Blood glucose levels and body weights of mice were measured on 0, 4, 7, 11 and 15th days. The study found that the extract was safe up to the dose level of 2000 mg/kg and the dose response effect of chloroform extract (150-250 mg/kg) of F. hurdwarica showed expressive antihyperglycemic effects and also improved other altered biochemical parameters associated with diabetes. The FTIR and XRD spectra demonstrated the occurrence of phenols, alcohols, alkenes, alkyl halides, ketones, and aromatic compounds and confirmed the amorphous nature of the extract. GC-MS spectral analysis showed the tentative presence of 31 phytochemical constituents in the chloroform extract of F. hurdwarica with different retention time. To conclude, the chloroform extract (250 mg/kg) of F. hurdwarica revealed considerable antioxidant, antihyperglycemic, and antihyperlipidemic potential and is safe for treating diabetes and related complications.

Diversity in National Society Leadership and Podium Speakers in Cardiothoracic Surgery.

BACKGROUND: Women and people of color are often underrepresented in medicine. This study examined the inclusivity and diversity of the recent history of the Canadian Association of Thoracic Surgeons (CATS) in both its executive committees and invited participation at its annual meeting. METHODS: CATS internal records and previous programs of CATS annual meetings were reviewed from 1997 to 2020. Leadership positions, invited speakers, and award recipients were categorized by sex and race. RESULTS: Of 199 CATS members in 2020, 93 (47%) were White men, 64 (32%) were men of color, 24 (12%) were White women, and 18 (9%) were women of color. The majority of CATS presidents (86%), committee chairs (57%), named lecturers (88%), other invited speakers (67%), and major award winners (90%) were White men. Women and people of color were underrepresented. The Resident Research Award was the most diverse: of 23 awards, 10 (44%) have been to men of color, 6 (26%) to White men, 4 (15%) to women of color, and 2 (8%) to White women. CONCLUSIONS: There is a need for more representation and inclusion of both women and people of color at multiple levels in CATS. This includes opportunities for improvement in the make-up of its executive committees, the speakers at its annual conference, and the recipients of its awards. CATS has established an Equity, Diversity and Inclusion Task Force to address this critical issue.

Efficacy and Safety of the Awake Prone Positioning in Patients with COVID-19 Related Respiratory Distress: A Scoping Review.

Prone positioning (PP) is becoming an important treatment modality for the management of COVID-19 related respiratory distress syndrome. The aim of this scoping review was to evaluate effectiveness and safety of awake PP in non-intubated patients with COVID-19 related acute respiratory distress at different care settings. The study was conducted during December 1, 2019 to August 30, 2020 using health science electronic databases and grey literature. A PRISMA flow diagram was used and finally 06 studies with 187 patients were included for review. Male patients were predominating with the mean age of approximately 55 years. Oxygenation was improved in 79.14% patients. One hundred fifty seven (83.95%) patients with COVID-19-related hypoxemic respiratory distress tolerated the procedure. Intubations required 25.41% of the patients or mechanical ventilation and 6(3.2%) patients expired. Number of patients in the reported studies could tolerate more than 3 hours of PP without a major side effect. Awake proning improved oxygenation of the patients suffering from COVID-19 related respiratory hypoxia in different care settings. Early instituted prone positioning may be an effective alternative method of treating COVID-19 related respiratory distress. Patient compliance and small size cohort studies are the limitations of this review. Multicenter controlled studies are warranted before conclusions are made about safety and the settings.

Correction: Multi-stage feature selection (MSFS) algorithm for UWB-based early breast cancer size prediction.

[This corrects the article DOI: 10.1371/journal.pone.0229367.].

Desmoplastic Fibroma of the Skull in an Infant: A Case Report.

Desmoplastic fibromas are rare benign bone tumors occurring primarily in long bones and mandible. In this case report, we present a desmoplastic fibroma originating from the left frontal bone. This is an exceptionally rare presentation of this pathology and the associated imaging and pathologic slides are highly educational. We discuss the relevance to the literature and how to manage these patients clinically.

Multi-stage feature selection (MSFS) algorithm for UWB-based early breast cancer size prediction.

Breast cancer is the most common cancer among women and it is one of the main causes of death for women worldwide. To attain an optimum medical treatment for breast cancer, an early breast cancer detection is crucial. This paper proposes a multi- stage feature selection method that extracts statistically significant features for breast cancer size detection using proposed data normalization techniques. Ultra-wideband (UWB) signals, controlled using microcontroller are transmitted via an antenna from one end of the breast phantom and are received on the other end. These ultra-wideband analogue signals are represented in both time and frequency domain. The preprocessed digital data is passed to the proposed multi- stage feature selection algorithm. This algorithm has four selection stages. It comprises of data normalization methods, feature extraction, data dimensional reduction and feature fusion. The output data is fused together to form the proposed datasets, namely, 8-HybridFeature, 9-HybridFeature and 10-HybridFeature datasets. The classification performance of these datasets is tested using the Support Vector Machine, Probabilistic Neural Network and Naïve Bayes classifiers for breast cancer size classification. The research findings indicate that the 8-HybridFeature dataset performs better in comparison to the other two datasets. For the 8-HybridFeature dataset, the Naïve Bayes classifier (91.98%) outperformed the Support Vector Machine (90.44%) and Probabilistic Neural Network (80.05%) classifiers in terms of classification accuracy. The finalized method is tested and visualized in the MATLAB based 2D and 3D environment.

High prevalence of human immunodeficiency virus, hepatitis B and C viral infections among people who inject drugs: a potential stumbling block in the control of HIV and viral hepatitis in Tanzania.

BACKGROUND: Tanzania has witnessed a significant decrease in the prevalence of human immunodeficiency virus (HIV) and viral hepatitis in the general population attributed to several interventional measures. It is uncertain whether this decline has also occurred among people who inject drugs (PWID). This study aimed to determine the seroprevalence of HIV, Hepatitis B and C viruses infection among PWID recruited from their hotspot sites in Dar es Salaam, Tanzania. METHODS: A cross-sectional study conducted between June and September 2017 recruited PWID from pre-identified hotspot sites using a snowball referral sampling technique. A structured questionnaire was used to obtain information regarding socio-demographic characteristics, behaviour and drug use. Blood was tested for the presence of IgG antibodies against HIV and Hepatitis C virus (HCV) and hepatitis B surface antigen (HBsAg). Data were entered in the computer using excel software and analysed using Statistical Package for Social Sciences version 20. RESULTS: A total of 219 PWID were recruited, the majority of whom were males (74.9%), unmarried (60.7%), had low education (62.6%) and low income (57.1%). The median age was 39 years, with an inter-quartile range of 35-43. Approximately 32.0% had a history of drug injection for more than 3 years, 79.9% were injecting drugs more than 3 times per day and 47.5% were sharing needles. The overall prevalence of HIV, HBsAg, and HCV was 33.8, 7.8, and 50.2%, respectively. There was serologic evidence of at least one infection for 68.9%, while 22.4% had two or more infections. HIV infection was independently associated with being married, while HCV was associated with injecting drugs for more than 3 years and unprotected sex. CONCLUSION: Over two-third of PWID had serologic evidence of infection with at least one virus while 22.4% having at least two infections. The high prevalence of HIV and viral hepatitis infections among PWID may hamper initiatives of ending HIV and viral hepatitis epidemics in Tanzania.

In Vitro Assessment of Coagulation Activities in Human Plasma Treated With Ajwa Date (Phoenix dactylifera L.) Extracts

Abstract@#Introduction: Arterial and venous thromboses contribute to significant morbidity and mortality rate, thus an antithrombotic agent is needed for prevention and treatment of thrombosis. Ajwa dates (Phoenix dactylifera L.) reportedly contain a high level of salicylic acid which is a compound responsible for anticoagulation via antagonism of vitamin K. The present study was designed to assess coagulation activities in human plasma treated with Ajwa date extracts in vitro. Methods: Platelet-poor plasma samples from 27 donors were treated with ethanol crude date extract (ET) or aqueous crude date extract (AQ) of Ajwa dates at different concentrations to generate the following seven test groups from each donor: control (normal saline), ET-I (0.1 g/mL), ET-II (0.5 g/mL), ET-III (1.0 g/mL), AQ-I (0.1 g/ mL), AQ-II (0.5 g/mL) and AQ-III (1.0 g/mL). In vitro coagulation activities of Ajwa dates were assessed based on prothrombin time (PT, an assessment of extrinsic coagulation pathway), activated partial thromboplastin time (APTT, an assessment of the intrinsic coagulation pathway), and thrombin time (TT, an evaluation of level and function of fibrinogen). Results: A very significant prolongation of PT, APTT and TT were observed for the ET-II and ET-III groups and very significant prolongation of PT and TT was observed for the AQ-II and AQ-III groups. Significant prolongation of TT was observed in the AQ-I group. Conclusion: In conclusion, Ajwa date extracts had an anticoagulation effect on human plasma.

Conservative management of extradural hematoma: A report of sixty-two cases.

BACKGROUND: Extradural hematomas (EDH) are considered life threatening in that the risk for brain herniation is significant. The current accepted understanding within the literature is to treat EDH via surgical evacuation of the hematoma. CASES: In this case-series we report 62 cases of EDH managed conservatively without surgical intervention. Inclusion criteria were: Glasgow comma scale score 13-15, extradural hematoma confirmed by CT being less than 40 mm, less than 6 mm of midline shift, and no other surgical lesions present. Patients were initially observed in a surgical intensive care unit prior to discharge and had closely scheduled follow-up. RESULTS: Of the 62 cases none required emergent intervention and the majority had interval resolution of the epidural hematoma over time. Resolution was apparent by 21 days and definitive by 3 to 6 months. CONCLUSION: Patients with EDH who have a high Glasgow comma scale score 13-15, volume <40 mm, and less than 6 mm of midline shift should be considered for conservative management. Our study indicates that these patients will have interval resolution of hematoma over time without worsening of symptoms.

Genetic analysis and identification of SSR markers associated with rice blast disease in a BC2F1 backcross population.

Rice (Oryza sativa L.) blast disease is one of the most destructive rice diseases in the world. The fungal pathogen, Magnaporthe oryzae, is the causal agent of rice blast disease. Development of resistant cultivars is the most preferred method to achieve sustainable rice production. However, the effectiveness of resistant cultivars is hindered by the genetic plasticity of the pathogen genome. Therefore, information on genetic resistance and virulence stability are vital to increase our understanding of the molecular basis of blast disease resistance. The present study set out to elucidate the resistance pattern and identify potential simple sequence repeat markers linked with rice blast disease. A backcross population (BC2F1), derived from crossing MR264 and Pongsu Seribu 2 (PS2), was developed using marker-assisted backcross breeding. Twelve microsatellite markers carrying the blast resistance gene clearly demonstrated a polymorphic pattern between both parental lines. Among these, two markers, RM206 and RM5961, located on chromosome 11 exhibited the expected 1:1 testcross ratio in the BC2F1 population. The 195 BC2F1 plants inoculated against M. oryzae pathotype P7.2 showed a significantly different distribution in the backcrossed generation and followed Mendelian segregation based on a single-gene model. This indicates that blast resistance in PS2 is governed by a single dominant gene, which is linked to RM206 and RM5961 on chromosome 11. The findings presented in this study could be useful for future blast resistance studies in rice breeding programs.

Subject-Specific Effect of Metallic Body Accessories on Path Loss of Dynamic on-Body Propagation Channels.

This paper presents the investigation of path loss variation for subject-specific on-body radio propagation channels, considering the effect of metallic spectacles and loop like metallic accessories. Adding metallic items may affect the operability of Body Centric Wireless Communications (BCWC). Measurements were carried out in an RF-shielded room lined with microwave absorbing sheets for strategically placed bodyworn antennas covering the upper front torso and the lower limbs. The path loss of the on-body radio channel was characterized explicitly taking into account the body size of the subjects. For metallic loop-like accessories, the results indicate that for underweight subjects, there was a slightly higher influence, up to 2%, compared to normal and overweight subjects. Our findings indicate that a noticeable effect exists on on-body channels for dynamic movements where the metallic watch acts as a local scatterer that affects the non-line-of-sight (NLOS) signal path between transmitter and receiver for underweight subjects in comparison to normal and overweight subjects. The path loss decreases when the receiving terminal was positioned very close to the metallic item. If a loop-like metallic accessory is not appropriately considered when designing the radio channel on a subject, the reliability of the body-centric wireless system may degrade.

Validation of the General Self-Efficacy Scale among Qatari young women.

The General Self-Efficacy Scale (GSES) is a measure of people's beliefs about their capacity to cope with life's demands. Self-efficacy may be particularly relevant in transitional stages such as in late adolescence, when young people make decisions that will impact their adult lives. In the present study, we aimed to validate an Arabic version of GSES among 355 Qatari young women aged 18+ years and finishing their final year of high school. We conducted exploratory and confirmatory factor analyses to assess the scale dimensionality. The final model fit was adequate (root mean square error of approximation = 0.07, comparative fit index = 1.00, Tucker-Lewis index = 0.99), confirming a unidimensional self-efficacy measure. The Qatari Standard Arabic GSES is a reliable tool for measuring general self-efficacy among young Qatari women.

Heavy Metal Dietary Intake and Potential Health Risks for University Hostel Students.

The study was conducted to determine the residual concentration of Cd, Pb, Asand Hg in some foodstuffs served to university students living at hostels of Beni-Suef University (BSU), Egypt, and to estimate the dietary intake of such metals, as well as to assess the potential health risks associated with the consumption of such foods. Therefore, a total of 200 samples, 50 each of, soft cheese, UHT milk, raw broiler carcasses and canned tuna, were periodically collected from university hostels of BSU and examined for the residual levels of these metals using atomic absorption spectrophotometer. The obtained results revealed that the mean residual levels of Cd in soft cheese, UHT milk, broiler's meat and canned tuna samples were 0.37, 0.26, 0.089 and 0.093 mg/kg, respectively, while those of Pb were 0.187, 0.20, 0.181 and 0.164 mg/kg, respectively. Regarding As, they were 0.196, 0.24, 0.14 and 0.201 mg/kg, respectively, and Hg mean residual concentration accounted for 0.05, 0.05, 0.117 and 0.235 mg/kg, respectively. Some of the examined food samples had heavy metals' concentrations above the international standards. The total weekly dietary intakes of Cd, Pb, As and Hg were 4.99, 5.38, 4.77 and 2.76 µg/kg bw/week, respectively, that were comparable to the provisional tolerable weekly intake recommended by the Joint Expert Committee on Food Additives (JECFA). The total target hazard quotient (TTHQ) of broiler's meat was over 1 (1.686), thus indicating possible health risks in contrast to the TTHQs of other foodstuffs that were below one.

Association between tumour necrosis-α gene polymorphisms and acne vulgaris in a Pakistani population.

BACKGROUND: The cytokine tumour necrosis factor (TNF)-α is a well-studied potent candidate mediator that is systemically involved in a variety of inflammatory diseases. Several single nucleotide polymorphisms (SNPs) of the TNF-α gene have been studied with regard the pathogenesis of acne vulgaris, but the results have been inconclusive. AIM: This case-control study investigated the association of the TNF -308 G>A and -238 G>A SNPs with acne vulgaris in a high-risk Pakistani population. METHODS: In total, 160 healthy controls and 140 patients with acne were enrolled in this study. Polymorphisms were determined by PCR and restriction fragment length polymorphism analysis. RESULTS: Our data showed that the TNF -308 G>A and TNF -238 G>A SNPs were present at a significantly higher rate in cases than in controls (P < 0.01 and P < 0.02; respectively). There was a significant difference between the G and A alleles from patients with acne and controls for -308 G>A (OR = 1.5, 95% CI = 1.07-2.19, P < 0.02) and -238 G>A (OR=1.6, 95% CI = 1.06-2.44, P = 0.02) genotype. Moreover, the severity of acne was significantly associated with TNF genotype (TNF -308 G>A: χ² = 34.6, P < 0.001; TNF -238 G>AL χ² = 12.9, P < 0.01). CONCLUSION: Our data suggest that the TNF -308 G>A and TNF -238 G>A SNPs may contribute to the pathogenesis of acne in the study population. Furthermore, patients with severe acne showed an increased frequency of mutant TNF genotypes at -308 and -238 compared with patients with less severe acne.

Effect of Short-Term Mobile Phone Base Station Exposure on Cognitive Performance, Body Temperature, Heart Rate and Blood Pressure of Malaysians.

Individuals who report their sensitivity to electromagnetic fields often undergo cognitive impairments that they believe are due to the exposure of mobile phone technology. The aim of this study is to clarify whether short-term exposure at 1 V/m to the typical Global System for Mobile Communication and Universal Mobile Telecommunications System (UMTS) affects cognitive performance and physiological parameters (body temperature, blood pressure and heart rate). This study applies counterbalanced randomizing single blind tests to determine if sensitive individuals experience more negative health effects when they are exposed to base station signals compared with sham (control) individuals. The sample size is 200 subjects with 50.0% Idiopathic Environmental Intolerance attributed to electromagnetic fields (IEI-EMF) also known as sensitive and 50.0% (non-IEI-EMF). The computer-administered Cambridge Neuropsychological Test Automated Battery (CANTAB eclipse(TM)) is used to examine cognitive performance. Four tests are chosen to evaluate Cognitive performance in CANTAB: Reaction Time (RTI), Rapid Visual Processing (RVP), Paired Associates Learning (PAL) and Spatial Span (SSP). Paired sample t-test on the other hand, is used to examine the physiological parameters. Generally, in both groups, there is no statistical significant difference between the exposure and sham exposure towards cognitive performance and physiological effects (P's > 0.05).