Background
This is the fourth updated Enhanced Recovery After Surgery (ERAS
®
) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded ...recommendations for each ERAS item within the ERAS
®
protocol.
Methods
A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.
Results
All recommendations on ERAS
®
protocol items are based on best available evidence; good-quality trials; meta-analyses of good-quality trials; or large cohort studies. The level of evidence for the use of each item is presented accordingly.
Conclusions
The evidence base and recommendation for items within the multimodal perioperative care pathway are presented by the ERAS
®
Society in this comprehensive consensus review.
Quantitative genetics, or the genetics of complex traits, is the study of those characters which are not affected by the action of just a few major genes. Its basis is in statistical models and ...methodology, albeit based on many strong assumptions. While these are formally unrealistic, methods work. Analyses using dense molecular markers are greatly increasing information about the architecture of these traits, but while some genes of large effect are found, even many dozens of genes do not explain all the variation. Hence, new methods of prediction of merit in breeding programmes are again based on essentially numerical methods, but incorporating genomic information. Long-term selection responses are revealed in laboratory selection experiments, and prospects for continued genetic improvement are high. There is extensive genetic variation in natural populations, but better estimates of covariances among multiple traits and their relation to fitness are needed. Methods based on summary statistics and predictions rather than at the individual gene level seem likely to prevail for some time yet.
Obesity is a risk factor for developing type 2 diabetes and cardiovascular disease and has quickly become a worldwide pandemic with few tangible and safe treatment options. Although it is generally ...accepted that the primary cause of obesity is energy imbalance, i.e., the calories consumed are greater than are utilized, understanding how caloric balance is regulated has proven a challenge. Many “distal” causes of obesity, such as the structural environment, occupation, and social influences, are exceedingly difficult to change or manipulate. Hence, molecular processes and pathways more proximal to the origins of obesity—those that directly regulate energy metabolism or caloric intake—seem to be more feasible targets for therapy. In particular, nitric oxide (NO) is emerging as a central regulator of energy metabolism and body composition. NO bioavailability is decreased in animal models of diet-induced obesity and in obese and insulin-resistant patients, and increasing NO output has remarkable effects on obesity and insulin resistance. This review discusses the role of NO in regulating adiposity and insulin sensitivity and places its modes of action into context with the known causes and consequences of metabolic disease.
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•Obesity is a major pandemic of the 21st century.•Decreased eNOS (NOS3) activity and abundance are commonly observed in obesity.•eNOS-derived NO has an antiobesogenic effect.•iNOS (NOS2) promotes insulin resistance.•NO derived from nNOS (NOS1) appears to regulate appetite.
Extracellular flux (XF) analysis has become a mainstream method for measuring mitochondrial function in cells and tissues. Although this technique is commonly used to measure bioenergetics in intact ...cells, we outline here a detailed XF protocol for measuring respiration in permeabilized cells. Cells are permeabilized using saponin (SAP), digitonin (DIG) or recombinant perfringolysin O (rPFO) (XF-plasma membrane permeabilizer (PMP) reagent), and they are provided with specific substrates to measure complex I- or complex II-mediated respiratory activity, complex III+IV respiratory activity or complex IV activity. Medium- and long-chain acylcarnitines or glutamine may also be provided for measuring fatty acid (FA) oxidation or glutamine oxidation, respectively. This protocol uses a minimal number of cells compared with other protocols and does not require isolation of mitochondria. The results are highly reproducible, and mitochondria remain well coupled. Collectively, this protocol provides comprehensive and detailed information regarding mitochondrial activity and efficiency, and, after preparative steps, it takes 6-8 h to complete.
Computational, thin-film deposition, and characterization approaches have been used to examine the ternary halide semiconductor Cs3Sb2I9. Cs3Sb2I9 has two known structural modifications, the 0-D ...dimer form (space group P63/mmc, no. 194) and the 2-D layered form (P3̅m1, no. 164), which can be prepared via solution and solid-state or gas-phase reactions, respectively. Our computational investigations suggest that the layered form, which is a one-third Sb-deficient derivative of the ubiquitous perovskite structure, is a potential candidate for high-band gap photovoltaic (PV) applications. In this work, we describe details of a two-step deposition approach that enables the preparation of large grain (>1 μm) and continuous thin films of the lead-free layered perovskite derivative Cs3Sb2I9. Depending on the deposition conditions, films that are c-axis oriented or randomly oriented can be obtained. The fabricated thin films show enhanced stability under ambient air, compared to methylammonium lead(II) iodide perovskite films stored under similar conditions, and an optical band gap value of 2.05 eV. Photoelectron spectroscopy study yields an ionization energy of 5.6 eV, with the valence band maximum approximately 0.85 eV below the Fermi level, indicating near-intrinsic, weakly p-type character. Density functional theory (DFT) analysis points to a nearly direct band gap for this material (less than 0.02 eV difference between the direct and indirect band gaps) and a similar high-level of absorption compared to CH3NH3PbI3. The photoluminescence peak intensity of Cs3Sb2I9 is substantially suppressed compared to that of CH3NH3PbI3, likely reflecting the presence of deep level defects that result in nonradiative recombination in the film, with computational results pointing to Ii, ISb, and VI as being likely candidates. A key further finding from this study is that, despite a distinctly layered structure, the electronic transport anisotropy is less pronounced due to the high ionicity of the I atoms and the strong antibonding interactions between the Sb s lone pair states and I p states, which leads to a moderately dispersive valence band.
The relative proportion of additive and non-additive variation for complex traits is important in evolutionary biology, medicine, and agriculture. We address a long-standing controversy and paradox ...about the contribution of non-additive genetic variation, namely that knowledge about biological pathways and gene networks imply that epistasis is important. Yet empirical data across a range of traits and species imply that most genetic variance is additive. We evaluate the evidence from empirical studies of genetic variance components and find that additive variance typically accounts for over half, and often close to 100%, of the total genetic variance. We present new theoretical results, based upon the distribution of allele frequencies under neutral and other population genetic models, that show why this is the case even if there are non-additive effects at the level of gene action. We conclude that interactions at the level of genes are not likely to generate much interaction at the level of variance.
Islets of Langerhans are anatomically dispersed within the pancreas and exhibit regulatory coordination between islets in response to nutritional and inflammatory stimuli. However, within individual ...islets, there is also multi-faceted coordination of function between individual beta-cells, and between beta-cells and other endocrine and vascular cell types. This is mediated partly through circulatory feedback of the major secreted hormones, insulin and glucagon, but also by autocrine and paracrine actions within the islet by a range of other secreted products, including somatostatin, urocortin 3, serotonin, glucagon-like peptide-1, acetylcholine, and ghrelin. Their availability can be modulated within the islet by pericyte-mediated regulation of microvascular blood flow. Within the islet, both endocrine progenitor cells and the ability of endocrine cells to trans-differentiate between phenotypes can alter endocrine cell mass to adapt to changed metabolic circumstances, regulated by the within-islet trophic environment. Optimal islet function is precariously balanced due to the high metabolic rate required by beta-cells to synthesize and secrete insulin, and they are susceptible to oxidative and endoplasmic reticular stress in the face of high metabolic demand. Resulting changes in paracrine dynamics within the islets can contribute to the emergence of Types 1, 2 and gestational diabetes.
In this work, we describe details of a two-step deposition approach that enables the preparation of continuous and well-structured thin films of Cs2SnI6, which is a one-half Sn-deficient 0-D ...perovskite derivative (i.e., the compound can also be written as CsSn0.5I3, with a structure consisting of isolated SnI6 4– octahedra). The films were characterized using powder X-ray diffraction (PXRD), scanning electron microscopy (SEM), thermogravimetric analysis (TGA), UV–vis spectroscopy, photoluminescence (PL), photoelectron spectroscopy (UPS, IPES, XPS), and Hall effect measurements. UV–vis and PL measurements indicate that the obtained Cs2SnI6 film is a semiconductor with a band gap of 1.6 eV. This band gap was further confirmed by the UPS and IPES spectra, which were well reproduced by the calculated density of states with the HSE hybrid functional. The Cs2SnI6 films exhibited n-type conduction with a carrier density of 6(1) × 1016 cm–3 and mobility of 2.9(3) cm2/V·s. While the computationally derived band structure for Cs2SnI6 shows significant dispersion along several directions in the Brillouin zone near the band edges, the valence band is relatively flat along the Γ–X direction, indicative of a more limited hole minority carrier mobility compared to analogous values for the electrons. The ionization potential (IP) and electron affinity (EA) were determined to be 6.4 and 4.8 eV, respectively. The Cs2SnI6 films show some enhanced stability under ambient air, compared to methylammonium lead(II) iodide perovskite films stored under similar conditions; however, the films do decompose slowly, yielding a CsI impurity. These findings are discussed in the context of suitability of Cs2SnI6 for photovoltaic and related optoelectronic applications.
In order to better manage anthropogenic CO2 emissions, improved methods of quantifying emissions are needed at all spatial scales from the national level down to the facility level. Although the ...Orbiting Carbon Observatory 2 (OCO‐2) satellite was not designed for monitoring power plant emissions, we show that in some cases, CO2 observations from OCO‐2 can be used to quantify daily CO2 emissions from individual middle‐ to large‐sized coal power plants by fitting the data to plume model simulations. Emission estimates for U.S. power plants are within 1–17% of reported daily emission values, enabling application of the approach to international sites that lack detailed emission information. This affirms that a constellation of future CO2 imaging satellites, optimized for point sources, could monitor emissions from individual power plants to support the implementation of climate policies.
Plain Language Summary
Burning coal for electricity generation accounts for more than 40% of humanity's current global CO2 emissions. To better manage CO2 emissions, improved methods of quantifying emissions are needed at all spatial scales. Although the Orbiting Carbon Observatory 2 (OCO‐2) satellite was not designed for monitoring power plant emissions, we show that in select cases, CO2 observations from OCO‐2 can be used to quantify daily CO2 emissions from individual middle‐ to large‐sized coal power plants by fitting the data to a simple model. Demonstrating the method on U.S. power plants with reliable reported emission data enabled application of the approach to international sites that have less or lower quality information available on emissions. Space agencies around the world are currently exploring how to design satellite missions to help address climate change and support Monitoring, Reporting and Verification (MRV) of CO2 emissions for climate agreements. This work affirms that a constellation of CO2 imaging satellites, with a design optimized for point sources, could monitor CO2 emissions from individual fossil fuel burning power plants to support that objective.
Key Points
The combustion of coal for electricity generation accounts for more than 40% of global anthropogenic CO2 emissions
Orbiting Carbon Observatory 2 observations can be used to quantify CO2 emissions from individual coal power plants, in selected cases
This work suggests that a future constellation of CO2 imaging satellites could monitor fossil fuel power plant CO2 emissions to support climate policy
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