Strong phylogenetic constraint on transition metal incorporation in the mandibles of the hyper-diverse Hymenoptera (Insecta)

In several groups of insects, body structures related to feeding and oviposition are known to have a hardened cuticle by incorporation of transition metals. However, a functional link between metal enrichment and ecological pressures (i.e., adaptation) has been only rarely shown, opening the possibility that in some lineages, the evolutionary history may account for most of the observed variation (i.e., phylogenetic constraint). Here, we addressed this question in the hyper-diverse Hymenoptera (bees, wasps, ants, and sawflies), in which Zn and/or Mn have been found enriching the mandibles of a number of species. Across 87 species spanning most of the extant superfamilies, we found Zn enrichment to be widespread (57 species). Although lacking in the most primitive “Symphyta”, our ancestral state reconstruction was not conclusive in determining whether Zn enrichment was a derived state for the complete order, but it was clearly the ancestral state for the Apocrita, where it was lost in few lineages, notably in Aculeata (where it was then reacquired at least three times). Mn, on the other hand, occurred very rarely in mandibles (10 species). Our comparative analysis revealed a strong phylogenetic effect explaining most Zn % and Mn % variation in mandibles. Additionally, species with herbivorous larvae were less prone to have Zn (but not Mn) than those with carnivorous larvae, although a causal effect of diet on this trait was unlikely. Furthermore, species emerging from concealed vs. unconcealed development sites have similar likelihood to have metal-enriched mandibles. Evolutionary history seems to constrain metal enrichment in hymenopteran mandibles, yet the few observed losses and regains of this trait during evolution claim for deeper investigations on the role of alternative, here untested, ecological pressures

Safety of Nonsteroidal Anti-inflammatory Drugs in Major Gastrointestinal Surgery: A Prospective, Multicenter Cohort Study

Background Significant safety concerns remain surrounding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) following gastrointestinal surgery, leading to wide variation in their use. This study aimed to determine the safety profile of NSAIDs after major gastrointestinal surgery. Methods Consecutive patients undergoing elective or emergency abdominal surgery with a minimum one-night stay during a 3-month study period were eligible for inclusion. The administration of any NSAID within 3 days following surgery was the main independent variable. The primary outcome measure was the 30-day postoperative major complication rate, as defined by the Clavien–Dindo classification (Clavien–Dindo III–V). Propensity matching with multivariable logistic regression was used to produce odds ratios (OR) and 95 % confidence intervals. Results From 9264 patients, 23.9 % (n = 2212) received postoperative NSAIDs. The overall major complication rate was 11.5 % (n = 1067). Following propensity matching and adjustment, use of NSAIDs were not significantly associated with any increase in major complications (OR 0.90, 0.60–1.34, p = 0.560). Conclusions Early use of postoperative NSAIDs was not associated with an increase in major complications following gastrointestinal surgery

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien\u2013Dindo Grades III\u2013V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49\u20132.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46\u20130.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease