Purpose
The aims were to compare the 5-year outcomes of duodenal switch (DS) and single-anastomosis duodenal switch (SADI-S) in terms of weight loss; remission of comorbidities; nutritional status ...short- and long-term complications; postoperative mortality; and need for revisional surgery.
Materials and Methods
Multicenter prospective observational study of all consecutive patients undergoing DS or SADI-S in three high-volume hospitals.
Results
A total of 87 patients were included in the study, 43 submitted to DS and 44 to SADI-S, with similar basal characteristics, nutritional parameters, and BMI (52.9 kg/m
2
DS vs. 52.5 kg/m
2
SADI-S). Operative time was 152 min (± 32.6) in DS vs. 116 min (± 21.9) in SADI-S (
p
= 0.043). Short-term complications were similar for DS and SADI-S, both overall (11.8% vs. 11.6%), and ranged as Clavien-Dindo > II (4.5% vs. 4.7%), with no mortality. At 5 years, DS and SADI-S results were as follows: BMI 30.6 vs. 33.3 kg/m
2
(
p
= 0.023); %EWL 80.5% vs. 68.6% (
p
= 0.006); and %TWL 42.1 vs. 36.0 (
p
= 0.006). Comorbidity remission rates for DS and SADI-S were as follows: for diabetes, 92.8% vs. 85.7% (n.s.); for hypertension, 95.2% vs. 85.1% (n.s.); for sleep apnea, 75% vs. 73.3% (n.s.); and for dyslipidemia, 76.4% vs. 73.3% (n.s.). DS showed lower levels of vitamin B
12
, iron, vitamin E, and zinc than SADI-S (
p
= < 0.005). In the long term, there were 4 surgical reinterventions (due to 1 internal hernia in the DS group and 1 internal hernia and 2 biliary refluxes in the SADI-S group) with no cases of persistent diarrhea or malnutrition.
Conclusion
Both DS and SADI-S allowed good weight control and resolution of comorbidities. DS achieved a greater weight loss compared to SADI-S, at the expense of longer operative time and lower vitamin and mineral levels.
Graphical abstract
Although frailty is a frequent occurrence in chronic obstructive pulmonary disease (COPD) patients, evidence on the frequency of frailty transition is scarce.
The present study aimed to describe the ...frailty status transition rates over a 2-year period and their associated clinical outcomes in stable COPD patients, and to determine predictors of improvement in frailty status.
We prospectively included 119 patients with stable COPD (mean age ± SD, 66.9 ± 7.9 years) over a follow-up period of 2 years. Frailty was assessed using the Fried criteria (unintentional weight loss, weakness, exhaustion, low activity level, and slow walking speed). Several demographic, clinical, and health-related variables were measured. We calculated the rates for each of the frailty transitions (no change, improvement, or worsening) between baseline and 2 years. Outcomes were compared using one-way analysis of variance and predictors of improvement were identified in multivariate logistic regression.
After 2 years of follow-up, 21 (17.6%) patients had an improved frailty status, 14 (11.7%) had worsened, and 84 (70.5%) had maintained the same frailty status. The worsening group (vs no change group) had greater dyspnea (p = 0.013) and disability (p = 0.036) and lower handgrip strength (p = 0.001). In contrast, the improved group (vs no change group) had greater handgrip (p<0.001) and quadriceps strength (p = 0.032). Furthermore, the improved group had greater handgrip strength (p<0.001), quadriceps strength (p = 0.003), physical activity (p = 0.008), and lower disability (p = 0.019) than the worsening group. Additionally, we determined that the 5STS test (≤ 13.6s) and exacerbations (≥ 2) were independent predictors for improvement in frailty status adjusted OR 9.46, p = 0.058 and adjusted OR 0.12, p = 0.026, respectively.
Frailty is a dynamic process for approximately one-third of patients with stable COPD and transitions in frailty status are associated with significant changes in clinical outcomes. The 5STS and exacerbations were independent predictors of improvement in frailty status.
The temperature effect on electronic transport mechanisms in graphene nanoplatelet (GNP) doped polydimethylsiloxane (PDMS) for temperature sensing applications has been investigated under electrical ...impedance spectroscopy (EIS) analysis. AC measurements showed a very prevalent frequency-dependent behavior in low filled nanocomposites due to the lower charge density. In fact, 4 wt % GNP samples showed a nonideal capacitive behavior due to scattering effects. Therefore, the standard RC-LRC circuit varies with the substitution of capacitive elements by CPEs, where a CPE is a constant phase element which denotes energy dissipation. In this regard, the temperature promotes a prevalence of scattering effects, with an increase of resistance and inductance and a decrease of capacitance values in both RC (intrinsic and contact mechanisms) and LRC (tunneling mechanisms) elements and, even, a change from ideal to nonideal capacitive behavior as in the case of 6 wt % GNP samples. In this way, a deeper understanding of electronic mechanisms depending on GNP content and temperature is achieved in a very intuitive way. Finally, a proof-of-concept carried out as temperature sensors showed a huge sensitivity (from 0.05 to 11.7 °C–1) in comparison to most of the consulted studies (below 0.01 °C–1), proving, thus, excellent capabilities never seen before for this type of application.
The purinergic receptor P2X7 (P2X7R) is implicated in all neurodegenerative diseases of the central nervous system. It is also involved in the retinal degeneration associated with glaucoma, ...age-related macular degeneration, and diabetic retinopathy, and its overexpression in the retina is evident in these disorders. Retinitis pigmentosa is a progressive degenerative disease that ultimately leads to blindness. Here, we investigated the expression of P2X7R during disease progression in the rd10 mouse model of RP. As the purinergic receptor P2X4 is widely co-expressed with P2X7R, we also studied its expression in the retina of rd10 mice. The expression of P2X7R and P2X4R was examined by immunohistochemistry, flow cytometry, and western blotting. In addition, we analyzed retinal functionality by electroretinographic recordings of visual responses and optomotor tests and retinal morphology. We found that the expression of P2X7R and P2X4R increased in rd10 mice concomitant with disease progression, but with different cellular localization. Our findings suggest that P2X7R and P2X4R might play an important role in RP progression, which should be further analyzed for the pharmacological treatment of inherited retinal dystrophies.
Ascorbic Acid (AA) is a natural and powerful water-soluble antioxidant associated with long-lasting food products. As time passes, the AA content in products sharply decreases, and they become ...increasingly degraded. There are several techniques to precisely quantify AA concentrations. However, most of them employ costly laboratory instruments, such as High-Performance Liquid Chromatography (HPLC) or complex electrochemical methods, which make unfeasible recurrent AA measurements along the entire supply chain. To address this issue, we contribute with an in-field and real-time voltammetric method, carried out with a low-cost, easy-to-use, and portable device. An unmodified Screen-Printed Electrode (SPE) is used together with the device to achieve short reading times. Our method has been extensively tested in two multifruit juices using three different SPEs. Calibration curves and Limit of Detection were derived for each SPE. Furthermore, periodic experiments were conducted to study the shelf life of juices under consideration. During the analysis, a set of assays for each SPE were implemented to determine the remaining AA amount per juice and compare it with that obtained using HPLC under the same conditions. Results revealed that our cost-effective device is fully comparable to the HPLC equipment, as long as the juice does not include certain interferents; a scenario also contemplated in this article.
SUMMARY
Microtremors are produced by multiple random sources close to the surface of the Earth. They may include the effects of multiple scattering, which suggests that their intensities could be ...well described by diffusion‐like equations. Within this theoretical framework, the average autocorrelation of the motions at a given receiver, in the frequency domain, measures average energy density and is proportional to the imaginary part of the Green's function (GF) when both source and receiver are the same.
Assuming the seismic field is diffuse we compute the H/V ratio for a surface receiver on a horizontally layered medium in terms of the imaginary part of the GF at the source. This theory links average energy densities with the GF in 3‐D and considers the H/V ratio as an intrinsic property of the medium. Therefore, our approach naturally allows for the inversion of H/V, the well‐known Nakamura's ratio including the contributions of Rayleigh, Love and body waves. Broad‐band noise records at Texcoco, a soft soil site near Mexico City, are studied and interpreted using this theory.
Although mobile applications (apps) are now widespread, to date few studies have considered the effects that app use has on loyalty towards the retailer. This study aims to explore the impact of ...affective and cognitive app experiences on loyalty towards retailers. A theoretical model, validated empirically with data from a survey using partial least squares structural equation modelling (PLS-SEM), is proposed. The results show the key role of affective experience and its impact on cognitive experience and that both dimensions positively influence the satisfaction and trust that users have in apps, which in turn has a positive effect on loyalty felt towards the retailer. These findings contribute towards improving the theoretical knowledge of the impact of apps on the retailer-customer relationship, and guide businesses in developing and implementing appropriate app-related strategies.
Automatic tracking of Caenorhabditis elegans (C. egans) in standard Petri dishes is challenging due to high-resolution image requirements when fully monitoring a Petri dish, but mainly due to ...potential losses of individual worm identity caused by aggregation of worms, overlaps and body contact. To date, trackers only automate tests for individual worm behaviors, canceling data when body contact occurs. However, essays automating contact behaviors still require solutions to this problem. In this work, we propose a solution to this difficulty using computer vision techniques. On the one hand, a skeletonization method is applied to extract skeletons in overlap and contact situations. On the other hand, new optimization methods are proposed to solve the identity problem during these situations. Experiments were performed with 70 tracks and 3779 poses (skeletons) of C. elegans. Several cost functions with different criteria have been evaluated, and the best results gave an accuracy of 99.42% in overlapping with other worms and noise on the plate using the modified skeleton algorithm and 98.73% precision using the classical skeleton algorithm.
Resilience is a protective health variable that contributes to successful adaptation to stressful experiences. However, in spite of its relevance, few studies have examined the psychophysiological ...and neuropsychological mechanisms involved in resilience. The present study analyzes, in a sample of 54 young women, the relationships between high‐ and low‐resilience, measured with the Spanish versions of Connor‐Davidson Resilience Scale questionnaire and the Resilience Scale, and two indices of psychophysiological and neuropsychological adaptability, the cardiac defense response (CDR) and cognitive flexibility. The CDR is a specific reaction to an unexpected intense noise characterized by two acceleration‐deceleration heart rate components. Cognitive flexibility, defined as the ability to adapt our behavior to changing environmental demands, is measured in this study with the CAMBIOS neuropsychological test. The results showed that the more resilient people, in addition to having better scores on mental health questionnaires, had a larger initial acceleration‐deceleration of the CDR‐indicative of greater vagal control, obtained better scores in cognitive flexibility, and evaluated the intense noise as less unpleasant than the less resilient people. No group differences were found in the second acceleration‐deceleration of the CDR‐indicative of sympathetic cardiac control, in the skin conductance response, or in subjective intensity of the noise. The present findings broaden the understanding of how resilient people change their adaptable responses to address environmental demands.
High‐ and low‐resilient women differ in two indices of psychophysiological and neuropsychological adaptability: cardiac defense and cognitive flexibility. Women with high‐resilience, compared to those with low‐resilience, had a more adaptive pattern of heart rate reactivity to a threat signal, and better cognitive flexibility performance. These indices suggest that resilience is linked to the ability to adapt behaviors to changing environments and to react to threatening cues with cognitive protective mechanisms, vagally mediated, aimed at interrupting ongoing activity, and increasing attention to the environmental changes.
The extension of the network lifetime of Wireless Sensor Networks (WSN) is an important issue that has not been appropriately solved yet. This paper addresses this concern and proposes some ...techniques to plan an arbitrary WSN. To this end, we suggest a hierarchical network architecture, similar to realistic scenarios, where nodes with renewable energy sources (denoted as primary nodes) carry out most message delivery tasks, and nodes equipped with conventional chemical batteries (denoted as secondary nodes) are those with less communication demands. The key design issue of this network architecture is the development of a new optimization framework to calculate the optimal assignment of renewable energy supplies (primary node assignment) to maximize network lifetime, obtaining the minimum number of energy supplies and their node assignment. We also conduct a second optimization step to additionally minimize the number of packet hops between the source and the sink. In this work, we present an algorithm that approaches the results of the optimization framework, but with much faster execution speed, which is a good alternative for large-scale WSN networks. Finally, the network model, the optimization process and the designed algorithm are further evaluated and validated by means of computer simulation under realistic conditions. The results obtained are discussed comparatively.
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