The SAGES masters program presents the 10 seminal articles for laparoscopic sleeve gastrectomy.

Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Masters Program includes eight distinct clinical pathways. The Bariatric Surgery Pathway focuses on three anchoring procedures, including the laparoscopic sleeve gastrectomy (LSG) which is the most commonly performed bariatric procedure in the United States. In this article, we present and discuss the top 10 seminal articles regarding the LSG.

Prognosis of Reflux Symptom Resolution After Bariatric Surgery: How Can Preoperative Esophageal Testing Help?

Purpose: The incidence of unresolved postoperative reflux after bariatric surgery varies considerably. Consistent perioperative patient characteristics predictive of unresolved reflux remain unknown. We leverage our institution's comprehensive preoperative esophageal testing to identify predictors of postoperative reflux.

Telemedicine Use Decreases the Carbon Footprint of the Bariatric Surgery Preoperative Evaluation.

Background: Healthcare-associated activity accounts for 10% of the United States' carbon dioxide (CO) emissions. Using telemedicine for bariatric surgery evaluations decreases emissions and reduces patient burden during the multiple required interdisciplinary visits. After adopting telemedicine during COVID, our clinic continues to utilize telemedicine for preoperative bariatric evaluations.

Preoperative esophageal testing predicts postoperative reflux status in sleeve gastrectomy patients.

Background: Patients who undergo vertical sleeve gastrectomy (VSG) are at risk of postoperative GERD. The reasons are multifactorial, but half of conversions to Roux-en Y gastric bypass are for intractable GERD. Our institution routinely performs preoperative pH and high-resolution manometry studies to aid in operative decision making.

Paradoxical Association of Hyperglycemia and Surgical Complications Among Patients With and Without Diabetes.

Importance: Surgical complications associated with perioperative hyperglycemia are conventionally associated with diabetes, but, paradoxically, prior cohort studies have found that patients without diabetes have greater risk of complications at similar levels of hyperglycemia compared with patients with diabetes.

Objective: To describe the association between perioperative hyperglycemia and surgical complications in a population of surgical patients without diabetes receiving routine blood glucose testing and insulin administration and to evaluate the potential correlation of perioperative hyperglycemia.

Design, Setting, And Participants: This retrospective cohort study of National Surgical Quality Improvement Program-defined complications after operation took place at a single academic medical center hospital from January 2013 to October 2016.

Evidence of depot-specific regulation of all-trans-retinoic acid biosynthesis in human adipose tissue.

The prevalence of obesity continues to rise, underscoring the need to better understand the pathways mediating adipose tissue (AT) expansion. All-trans-retinoic acid (atRA), a bioactive vitamin A metabolite, regulates adipogenesis and energy metabolism, and, in rodent studies, aberrant vitamin A metabolism appears a key facet of metabolic dysregulation. The relevance of these findings to human disease is unknown, as are the specific enzymes implicated in vitamin A metabolism within human AT.

Characteristics and outcomes of patients undergoing paraesophageal hernia repair with selective use of biologic mesh.

Background: The use of biologic mesh in paraesophageal hernia repair (PEHR) has been associated with decreased short-term recurrence but no statistically significant difference in long-term recurrence. Because of this, we transitioned from routine to selective use of mesh for PEHR. The aim of this study was to examine our indications for selective mesh use and to evaluate patient outcomes in this population.

Use of post-discharge heparin prophylaxis and the risk of venous thromboembolism and bleeding following bariatric surgery.

Introduction: Venous thromboembolism (VTE) is a significant cause of morbidity and mortality after bariatric surgery. Roughly 80% of VTEs occur post-discharge. The frequency of post-discharge heparin (PDH) prophylaxis use is unknown, and evidence about benefits and risks is limited.

Lowest Acceptable Bladder Capacity for Interpretation of Uroflowmetry Tests in Children.

Objective: To determine the age-specific lowest acceptable value of bladder capacity (LABC) for interpretation of uroflowmetry tests in children.

Methods: From September 2008 through July 2012, healthy children aged 4-9 years were enrolled. All children were asked to have two sets of uroflowmetry and post-void residual (PVR) tests.

Risk factors for depressive symptoms in glaucoma patients: a nationwide case-control study.

Purpose: The purpose was to investigate the risk factors for depressive symptoms in glaucoma patients.

Methods: From the Longitudinal Health Insurance Database in Taiwan, we included 1190 glaucoma patients with subsequent depression diagnoses in the case group and randomly selected 4673 glaucoma patients without depression diagnoses as the control group, matched by age, sex, and time of glaucoma diagnosis. The age-adjusted Charlson comorbidity index (ACCI) score was used to compute the burden of comorbidity for each patient.

Laparoscopic adrenal metastasectomy: appropriate, safe, and feasible.

Background: The role of adrenalectomy in management of isolated metastatic adrenal tumors is increasingly established. Laparoscopy is becoming the preferred approach for these resections. We evaluated surgical and oncological outcomes of patients who underwent laparoscopic versus open adrenal metastasectomy and assessed the effect of such surgery on postoperative adjuvant therapy and survival.

Paramagnet enhanced nuclear spin relaxation in H2O@Open-C60 and H2@Open-C60.

Relaxation rates of endo-H2O in H2O@Open-C60 in the presence of a nitroxide radical and of their nitroxide derivatives have been measured and are compared with effects for endo-H2 in similar cages. T1 relaxation enhancement of the endo-H2O and H2 induced by either intra- or intermolecular interaction is relatively insensitive to the presence of a cage opening. Enhancement of intermolecular relaxation is observed, however, when the cage opening has an OH group.

Nuclear spin isomers of guest molecules in H₂@C₆₀, H₂O@C₆₀ and other endofullerenes.

Spectroscopic studies of recently synthesized endofullerenes, in which H₂, H₂O and other atoms and small molecules are trapped in cages of carbon atoms, have shown that although the trapped molecules interact relatively weakly with the internal environment they are nevertheless susceptible to appropriately applied external perturbations. These properties have been exploited to isolate and study samples of H₂ in C₆₀ and other fullerenes that are highly enriched in the para spin isomer. Several strategies for spin-isomer enrichment, potential extensions to other endofullerenes and possible applications of these materials are discussed.

Nuclear magnetic resonance of hydrogen molecules trapped inside C70 fullerene cages.

We present a solid-state NMR study of H2 molecules confined inside the cavity of C70 fullerene cages over a wide range of temperatures (300 K to 4 K). The proton NMR spectra are consistent with a model in which the dipole-dipole coupling between the ortho-H2 protons is averaged over the rotational/translational states of the confined quantum rotor, with an additional chemical shift anisotropy δ(H)(CSA)=10.1 ppm induced by the carbon cage.

Quantum rotation of ortho and para-water encapsulated in a fullerene cage.

Inelastic neutron scattering, far-infrared spectroscopy, and cryogenic nuclear magnetic resonance are used to investigate the quantized rotation and ortho-para conversion of single water molecules trapped inside closed fullerene cages. The existence of metastable ortho-water molecules is demonstrated, and the interconversion of ortho-and para-water spin isomers is tracked in real time. Our investigation reveals that the ground state of encapsulated ortho water has a lifted degeneracy, associated with symmetry-breaking of the water environment.

New bundled world: quality of care and readmission in diabetes patients.

Background: Hospital readmissions among patients with diabetes are substantial and costly. Although prior studies have shown that receipt of outpatient quality of care significantly reduces the risk of hospitalization among patients with diabetes, little is known about its impact on hospital readmission. The objective of this study is to assess the impact of outpatient quality of care on 30-day readmission among patients with diabetes.

Comparison of Nuclear Spin Relaxation of H2O@C60 and H2@C60 and Their Nitroxide Derivatives.

The successful synthesis of H2O@C60 makes possible the study of magnetic interactions of an isolated water molecule in a geometrically well-defined hydrophobic environment. Comparisons are made between the T1 values of H2O@C60 and the previously studied H2@C60 and their nitroxide derivatives. The value of T1 is approximately six times longer for H2O@C60 than for H2@C60 at room temperature, is independent of solvent viscosity or polarity, and increases monotonically with decreasing temperature, implying that T1 is dominated by the spin-rotation interaction.

A photochemical on-off switch for tuning the equilibrium mixture of H2 nuclear spin isomers as a function of temperature.

The photochemical interconversion of the two allotropes of the hydrogen molecule [para-H(2) (pH(2)) and ortho-H(2) (oH(2))] incarcerated inside the fullerene C(70) (pH(2)@C(70) and oH(2)@C(70), respectively) is reported. Photoexcitation of H(2)@C(70) generates a fullerene triplet state that serves as a spin catalyst for pH(2)/oH(2) conversion. This method provides a means of changing the pH(2)/oH(2) ratio inside C(70) by simply irradiating H(2)@C(70) at different temperatures, since the equilibrium ratio is temperature-dependent and the electronic triplet state of the fullerene produced by absorption of the photon serves as an "on-off" spin catalyst.

Heart failure patients receiving ACEIs/ARBs were less likely to be hospitalized or to use emergency care in the following year.

Angiotensin-converting enzyme inhibitors (ACEIs) have been shown to decrease morbidity and mortality in heart failure (HF) patients in randomized-controlled trials; observational studies have confirmed this benefit among patients discharged with HF. Investigating the benefit of ACEIs or angiotensin receptor blockers (ARBs) among general HF patients has important implications for quality-of-care measurement and quality initiatives. The objective of this study is to assess the impact of receipt of ACEIs/ARBs among patients with HF on hospitalization, emergency care, and healthcare cost during the following year.

Does pay for performance improve cardiovascular care in a "real-world" setting?

The objective was to investigate the impact of a pay-for-performance program (P4P) on quality care and outcomes among cardiovascular disease (CVD) patients. Claims data were used to identify CVD patients in a commercial plan in 1999-2006. Multivariate analyses were employed to examine the impact of P4P on quality care (lipid monitoring and treatment) and quality care on outcomes (new coronary events, hospitalizations, and lipid control).

HIV screening in commercially insured patients screened or diagnosed with sexually transmitted diseases or blood-borne pathogens.

Background: The Centers for Disease Control strongly recommends HIV screening for all patients who present to health care settings with sexually transmitted diseases (STD) or blood-borne pathogens exposure. The objective of this study is to assess the rates and determinants of HIV screening in a national sample of commercially insured patients screened or diagnosed with an STD or hepatitis B or C.

Methods: We used Poisson regression model with a robust error variance to assess the determinants of HIV screening using administrative claims data from health plans across 6 states (n = 270,423).

Comparative NMR properties of H2 and HD in toluene-d8 and in H2/HD@C60.

Spin-lattice relaxation times, T(1), have been measured from 200-340 K for the protons in H(2) and HD molecules dissolved in toluene-d(8) and incarcerated in C(60). It is found that HD relaxes more slowly than H(2) in both environments and at all temperatures, as expected from the smaller values of the spin-rotation and dipole-dipole coupling in HD compared to H(2). More detailed analysis using models developed to describe relaxation in both condensed media and the gas phase indicates that transitions among the rotational states of H(2) occur at a rate similar to those of HD in both toluene-d(8) solution and in C(60), in contrast to the situation in gas phase collisions between hydrogen and He or Ar, where the lifetimes of rotational states of HD are markedly shorter than those for H(2).

A magnetic switch for spin-catalyzed interconversion of nuclear spin isomers.

The interconversion of ortho-hydrogen (oH(2)) and para-hydrogen (pH(2)), the two nuclear spin isomers of dihydrogen, requires a paramagnetic spin catalyst such as a nitroxide. We report the design and demonstration of spin catalysis of the interconversion of oH(2) and pH(2) incarcerated in an endofullerene based on a reversible nitroxide/hydroxylamine system. The system is an example of a reversible magnetic spin catalysis switch that can increase the rate of interconversion of the nuclear spin isomers of H(2) by a factor of approximately 10(4).

Impact of a pay-for-performance program on low performing physicians.

Studies have shown that the lowest performing physicians in pay-for-performance (P4P) programs improved the most; however, it is unclear whether this would occur without the P4P program or be sustained. The objective of this study is to investigate the impact of P4P in a Preferred Provider Organization (PPO) on low performing physicians over a 4-year period. We used administrative claims data from a PPO health plan in Hawaii, which implemented a P4P program, and a PPO plan in the South, which did not implement a P4P program.