A comparative analysis of robotic versus laparoscopic total pancreatectomy: insights from the National Cancer Database.

Total pancreatectomy is a complex procedure used in the management of pancreatic cancer. While minimally invasive techniques have been increasingly adopted, limited data exist comparing robotic total pancreatectomy (RTP) and laparoscopic total pancreatectomy (LTP). This study evaluates the utilization, short- and long-term outcomes of RTP and LTP using the National Cancer Database.

Protocolized Gastrointestinal Fistula Management is Superior to Historic Data and National Averages: A Retrospective Review of an Enterocutaneous Fistula Registry.

Enterocutaneous fistula (ECF) management remains a complex clinical problem. Prehabilitation (prehab) protocols are becoming more popular. The prehabilitation protocol used in this paper was adopted in 2017 at the University of Florida.

The Novel Use of Magtrace in Chest Masculinizing Transgender Top Surgery.

Chest masculinization is the most common surgery performed in transgender men, and although incidence of occult cancer is lower than in cis-gender women receiving mastectomy or reduction mammoplasties, the incidence of high-risk lesions is comparable. In patients with concerns for occult malignancy, Magtrace is a nonradioactive tracer available to assist management for its delayed sentinel lymph node mapping capabilities. We present the first case report using Magtrace before masculinizing mastectomies in a transgender man.

Robust rank-based meta-analyses for two-sample designs with application to platelet counts of malaria infection data.

In this paper, we propose robust meta-analysis procedures for individual studies that report a broad range of robust summary statistics for a two-sample problem. Summary statistics of individual studies could be presented in different forms including full data, medians of the two samples, the Hodges-Lehman and Wilcoxon estimates of the location shift parameters. Data synthesis is made under both fixed-effect and random-effect meta-analysis models.

Least Squares and Robust Rank-Based Double Bootstrap Analyses for Time-Series Intervention Designs.

Time-series intervention designs that include two or more phases have been widely discussed in the healthcare literature for many years. A convenient model for the analysis of these designs has a linear model part (to measure changes in level and trend) plus a second part that measures the random error structure; the error structure is assumed to follow an autoregressive time-series process. Traditional generalized linear model approaches widely used to estimate this model are less than satisfactory because they tend to provide substantially biased intervention tests and confidence intervals.

Climate Change Shrinks and Fragments Salmon Habitats in a Snow-Dependent Region.

Climate change threatens biodiversity through global alteration of habitats, but efficient conservation responses are often hindered by imprecise downscaling of impacts. Besides thermal effects, warming also drives important ancillary environmental changes, such as when river hydrology evolves in response to climate forcing. Earlier snowmelt runoff and summer flow declines are broadly manifested in snow-dependent regions and relevant to socioeconomically important cold-water fishes.

Some (Fish Might) Like It Hot: Habitat Quality and Fish Growth from Past to Future Climates.

Current expectation is that projected climate change may have adverse effects on fish habitats and survival. The analysis leading to these concerns is typically done at large scale with limited possibility to quantify the local biological response and compare with previous conditions. Our research investigated the effects of recorded climate conditions on Chinook salmon () spawning and rearing habitats and growth responses to the local climate and compared those conditions to predicted responses to a climate change.

Comparison of Antimicrobial Resistance Profiles in spp. from Swine Upon Arrival and Postslaughter at the Abattoir.

Antimicrobial resistance (AMR) developed by within animals used for food products is a major global issue. Monitoring AMR in animals destined for slaughter is, therefore, critical. Abattoirs may serve as potential candidate checkpoints for monitoring resistance patterns on farms.

Pseudomonal Meningoencephalitis With Ventriculitis Secondary to Bacteremia in a Burn Patient: A Novel Case.

Burn patients with large burn surface area involvement are at increased risk of infection due to the presence of large wounds, multiple surgeries, prolonged intensive care unit admission, and immunosuppression. Pseudomonas aeruginosa is the most commonly isolated organism in this population. Even with frequent infections in the burn population, meningitis and encephalitis are rare, and ventriculitis is exceptional.

Publisher Correction: A dynamically cold disk galaxy in the early Universe.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

A dynamically cold disk galaxy in the early Universe.

The extreme astrophysical processes and conditions that characterize the early Universe are expected to result in young galaxies that are dynamically different from those observed today. This is because the strong effects associated with galaxy mergers and supernova explosions would lead to most young star-forming galaxies being dynamically hot, chaotic and strongly unstable. Here we report the presence of a dynamically cold, but highly star-forming, rotating disk in a galaxy at redshift z = 4.

Traditional and Rank-Based Tests for Ordered Alternatives in a Cluster Correlated Model.

Methods for the analysis of one-factor randomized groups designs with ordered treatments are well established, but they do not apply in the case of more complex experiments. This article describes ordered treatment methods based on maximum-likelihood and robust estimation that apply to designs with clustered data, including those with a vector of covariates. The contrast coefficients proposed for the ordered treatment estimates yield higher power than those advocated by Abelson and Tukey; the proposed robust estimation method is shown (using theory and simulation) to yield both high power and robustness to outliers.

Mechanisms for the reduction of caffeine consumption: What, how and why.

Background: Anecdotal evidence suggests consumers of caffeine self-administer strategies to reduce consumption, but little is known of what these strategies are or how they are implemented. This study aimed to understand the lived experience of reducing caffeine consumption including specific techniques (what) and implementation strategies (how), harm and withdrawal symptoms (why).

Methods: We developed a classification system through an inductive and deductive approach and applied it to a large dataset derived from online sources.

Ankle Fracture Epidemiology in the United States: Patient-Related Trends and Mechanisms of Injury.

Current nationwide epidemiological data regarding ankle fractures are scarce. Such information is important towards better quantifying the mortality associated with such injuries, financial impact, as well as the implementation of preventative measures. This study evaluated the epidemiology of ankle fractures that occurred during a 5-year period.

I was truly addicted to sugar: A consumer-focused classification system of behaviour change strategies for sugar reduction.

The reduction of free sugars has been identified as a priority issue internationally. A range of public health initiatives have been recommended, including the provision of information and support for sugar reduction. To inform these approaches, it is important to know what people actually do in real world settings to reduce their consumption.

Difficulties for cost-benefit analysis in the 2020 environmental impact statement to recover the endangered wild salmon and steelhead in the Columbia River Basin.

Runs of the endangered wild salmon/steelhead in the Columbia River basin may be only two to seven percent of historic levels. These fish are a common-pool resource, where stakeholders over-consume, pollute rivers and oceans, block passage with dams and culverts, operate net pen fish farms, and plant huge numbers of hatchery fish that compete with and hybridize wild fish. Rivers provide free or subsidized services that stakeholders covet, however recovery of the endangered wild fish requires that peoples utilizing the rivers and the ocean must constrain their behavior, often reducing their profit.

Dam operations may improve aquatic habitat and offset negative effects of climate change.

Dam operation impacts on stream hydraulics and ecological processes are well documented, but their effect depends on geographical regions and varies spatially and temporally. Many studies have quantified their effects on aquatic ecosystem based mostly on flow hydraulics overlooking stream water temperature and climatic conditions. Here, we used an integrated modeling framework, an ecohydraulics virtual watershed, that links catchment hydrology, hydraulics, stream water temperature and aquatic habitat models to test the hypothesis that reservoir management may help to mitigate some impacts caused by climate change on downstream flows and temperature.

Probiotics and Subclinical Psychological Symptoms in Healthy Participants: A Systematic Review and Meta-Analysis.

Introduction/aim: Interest in the gut-brain axis and emerging evidence that the intestinal microbiota can influence central nervous system function has led to the hypothesis that probiotic supplementation can have a positive effect on mood and psychological symptoms such as depression and anxiety. Although several human clinical trials have investigated this, results have been inconsistent. Therefore, a systematic review and meta-analytic approach was chosen to examine if probiotic consumption has an effect on psychological symptoms.

Sphingosylphosphorylcholine inhibits macrophage adhesion to vascular smooth muscle cells.

Inflammation in de-endothelialised arteries contributes to the development of cardiovascular diseases. The process that initiates this inflammatory response is the adhesion of monocytes/macrophages to exposed vascular smooth muscle cells, typically stimulated by cytokines such as tumour necrosis factor-α (TNF). The aim of this study was to determine the effect of the sphingolipid sphingosylphosphorylcholine (SPC) on the interaction of monocytes/macrophages with vascular smooth muscle cells.

Abdominal Pain in the Immunocompromised Patient-Human Immunodeficiency Virus, Transplant, Cancer.

Patients with human immunodeficiency virus, those who are posttransplant, and those undergoing chemotherapy are populations who are immunocompromised and present to the emergency department with abdominal pain related to their disease processes, opportunistic infections, and complications of treatment. Emergency department practitioners must maintain vigilance, as the physical examination is often unreliable in these patients. Cross-sectional imaging and early treatment of symptoms with aggressive resuscitation is often required.

Intimate Partner Violence Associated with Postpartum Depression, Regardless of Socioeconomic Status.

Objective This study examined whether socioeconomic status moderated the association between intimate partner violence (IPV) and postpartum depression among a community-based sample of women. Defining the role of poverty in the risk of postpartum depression for IPV victims enables prioritization of health promotion efforts to maximize the effectiveness of existing maternal-infant resources. Methods This cross-sectional telephone-survey study interviewed 301 postpartum women 2 months after delivery, screening them for IPV and depression [using Edinburgh Postnatal Depression Scale (EPDS)].