Development of growth rate, body lipid, moisture, and energy models for white sturgeon (Acipenser transmontanus) fed at various feeding rates.

The objectives were to develop and evaluate: 1) growth rate models, 2) body lipid, moisture, and energy models for white sturgeon fed at various feeding rates (FR; % body weight [BW] per day) and then evaluate responses at proportions of optimum feeding rate (OFR) across increasing BW (g). For objective 1, 19 datasets from the literature containing initial BW, FR and specific growth rate (SGR; % BW increase per day) were used. For objective 2, 12 datasets from the literature (11 from objective 1) containing SGR, FR, final BW, body lipid (%), protein (%), ash (%), moisture (%), and energy (kJ/g) were used. The average rearing temperatures was 19.2 ± 1.5 °C (mean ± SD). The average nutrient compositions and gross energy of the diets were 45.7 ± 4.3% protein, 14.8 ± 3.2% lipid, and 20.4 ± 1.3 kJ/g, respectively. The logistic model was used for objectives 1 and 2 to develop a statistical relationship between SGR and FR, then an iterative technique was used to estimate OFR for each dataset. For objective 2, the statistical relationship between body lipid, energy, and moisture and FR was established. Using the OFR estimate, SGR, body lipid, energy and moisture were computed at various FR as a proportion of OFR. Finally, a nonparametric fitting procedure was used to establish relationships between SGR, body lipid, energy and moisture (responses) compared with BW (predictor) at various proportions of OFR. This allows visualization of the effect of under- or over-feeding on the various responses. When examining the differences between OFR at 100% and various proportions of OFR, SGR differences decrease and moisture differences increase as BW increases. Lipid and energy differences decrease as BW increases. To our knowledge, these are the first description of changes in nutrient compositions when white sturgeon are fed at various FR. Because physiological and behavioral properties that are unique to sturgeon, results from this study are specific to sturgeon under the conditions of this study and cannot be compared directly with salmonids even if some of the results are similar. This research provides insight to designing future nutritional studies in sturgeon

TagScan: Simultaneous target imaging and material identification with commodity RFID devices

National Research Foundation (NRF) Singapore under IDM Futures Funding Initiativ

Effect of parasympathetic stimulation on brain activity during appraisal of fearful expressions

Autonomic nervous system activity is an important component of human emotion. Mental processes influence bodily physiology, which in turn feeds back to influence thoughts and feelings. Afferent cardiovascular signals from arterial baroreceptors in the carotid sinuses are processed within the brain and contribute to this two-way communication with the body. These carotid baroreceptors can be stimulated non-invasively by externally applying focal negative pressure bilaterally to the neck. In an experiment combining functional neuroimaging (fMRI) with carotid stimulation in healthy participants, we tested the hypothesis that manipulating afferent cardiovascular signals alters the central processing of emotional information (fearful and neutral facial expressions). Carotid stimulation, compared with sham stimulation, broadly attenuated activity across cortical and brainstem regions. Modulation of emotional processing was apparent as a significant expression-by-stimulation interaction within left amygdala, where responses during appraisal of fearful faces were selectively reduced by carotid stimulation. Moreover, activity reductions within insula, amygdala, and hippocampus correlated with the degree of stimulation-evoked change in the explicit emotional ratings of fearful faces. Across participants, individual differences in autonomic state (heart rate variability, a proxy measure of autonomic balance toward parasympathetic activity) predicted the extent to which carotid stimulation influenced neural (amygdala) responses during appraisal and subjective rating of fearful faces. Together our results provide mechanistic insight into the visceral component of emotion by identifying the neural substrates mediating cardiovascular influences on the processing of fear signals, potentially implicating central baroreflex mechanisms for anxiolytic treatment targets

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Comparison of acrylamide intake from Western and guideline based diets using probabilistic techniques and linear programming

The article of record as published may be found at http://dx.doi.org/10.1016/j.fct.2011.11.006Western and guideline based diets were compared to determine if dietary improvements resulting from following dietary guidelines reduce acrylamide intake. Acrylamide forms in heat treated foods and is a human neurotoxin and animal carcinogen. Acrylamide intake from the Western diet was estimated with probabilistic techniques using teenage (13–19 years) National Health and Nutrition Examination Survey (NHANES) food consumption estimates combined with FDA data on the levels of acrylamide in a large number of foods. Guideline based diets were derived from NHANES data using linear programming techniques to comport to recommendations from the Dietary Guidelines for Americans, 2005. Whereas the guideline based diets were more properly balanced and rich in consumption of fruits, vegetables, and other dietary components than the Western diets, acrylamide intake (mean ± SE) was significantly greater (P < 0.001) from consumption of the guideline based diets (0.508 ± 0.003 lg/kg/day) than from consumption of the Western diets (0.441 ± 0.003 lg/kg/day). Guideline based diets contained less acrylamide contributed by French fries and potato chips than Western diets. Overall acrylamide intake, however, was higher in guideline based diets as a result of more frequent breakfast cereal intake. This is believed to be the first example of a risk assessment that combines probabilistic techniques with linear programming and results demonstrate that linear programming techniques can be used to model specific diets for the assessment of toxicological and nutritional dietary components.Approved for public release; distribution is unlimited

Development of growth rate, body lipid, moisture, and energy models for white sturgeon (Acipenser transmontanus) fed at various feeding rates.

The objectives were to develop and evaluate: 1) growth rate models, 2) body lipid, moisture, and energy models for white sturgeon fed at various feeding rates (FR; % body weight [BW] per day) and then evaluate responses at proportions of optimum feeding rate (OFR) across increasing BW (g). For objective 1, 19 datasets from the literature containing initial BW, FR and specific growth rate (SGR; % BW increase per day) were used. For objective 2, 12 datasets from the literature (11 from objective 1) containing SGR, FR, final BW, body lipid (%), protein (%), ash (%), moisture (%), and energy (kJ/g) were used. The average rearing temperatures was 19.2 ± 1.5 °C (mean ± SD). The average nutrient compositions and gross energy of the diets were 45.7 ± 4.3% protein, 14.8 ± 3.2% lipid, and 20.4 ± 1.3 kJ/g, respectively. The logistic model was used for objectives 1 and 2 to develop a statistical relationship between SGR and FR, then an iterative technique was used to estimate OFR for each dataset. For objective 2, the statistical relationship between body lipid, energy, and moisture and FR was established. Using the OFR estimate, SGR, body lipid, energy and moisture were computed at various FR as a proportion of OFR. Finally, a nonparametric fitting procedure was used to establish relationships between SGR, body lipid, energy and moisture (responses) compared with BW (predictor) at various proportions of OFR. This allows visualization of the effect of under- or over-feeding on the various responses. When examining the differences between OFR at 100% and various proportions of OFR, SGR differences decrease and moisture differences increase as BW increases. Lipid and energy differences decrease as BW increases. To our knowledge, these are the first description of changes in nutrient compositions when white sturgeon are fed at various FR. Because physiological and behavioral properties that are unique to sturgeon, results from this study are specific to sturgeon under the conditions of this study and cannot be compared directly with salmonids even if some of the results are similar. This research provides insight to designing future nutritional studies in sturgeon