Safety and effectiveness of bariatric surgery: Roux-en-y gastric bypass is superior to gastric banding in the management of morbidly obese patients: a reply to the response by Bhoyrul et al

<p>Abstract</p> <p>Background</p> <p>We have read the letter by Bhoyrul et al. in response to our recently published article "<it>Safety and effectiveness of bariatric surgery: Roux-en-Y gastric bypass is superior to gastric banding in the management of morbidly obese patients"</it>. We strongly disagree with the content of the letter.</p> <p>Results and discussion</p> <p>Bhoyrul et al. base their letter mostly on low level evidence such as single-institutional case series (level IV evidence) and expert opinion (level V evidence). Surprisingly, they do not comment on the randomized controlled trial, which clearly favours gastric bypass over gastric banding.</p> <p>Conclusion</p> <p>The letter by Bhoyrul et al. is based on low level evidence and is itself biased, unsubstantiated, and not supported by the current literature.</p

Perianal basal cell carcinoma: a common cancer in an uncommon location.

This is a case of a perianal basal cell carcinoma, a common skin cancer in an unusual location. Our patient is a 67-year-old male with a perianal lesion. He first noticed this painless lesion 5 years prior to presentation and was having fecal incontinence and weight loss. He had a fully encompassing ulcerated lesion involving the entirety of the anal margin. We performed a biopsy that returned on pathology as a basal cell carcinoma. Due to the size of the lesion and his current nutritional status, it was determined to be unresectable. We were able to provide him with a diverting colostomy to address his incontinence and this allowed the patient to recover enough to undergo treatment with radiation (total of 5400 cGy). To our knowledge, this is the largest perianal basal cell carcinoma reported in the literature and an example of combining palliative surgery and radiation as a treatment option

Month-Timescale Optical Variability in the M87 Jet

A previously inconspicuous knot in the M87 jet has undergone a dramatic outburst and now exceeds the nucleus in optical and X-ray luminosity. Monitoring of M87 with the Hubble Space Telescope and Chandra X-ray Observatory during 2002-2003, has found month-timescale optical variability in both the nucleus and HST-1, a knot in the jet 0.82'' from the nucleus. We discuss the behavior of the variability timescales as well as spectral energy distribution of both components. In the nucleus, we see nearly energy-independent variability behavior. Knot HST-1, however, displays weak energy dependence in both X-ray and optical bands, but with nearly comparable rise/decay timescales at 220 nm and 0.5 keV. The flaring region of HST-1 appears stationary over eight months of monitoring. We consider various emission models to explain the variability of both components. The flares we see are similar to those seen in blazars, albeit on longer timescales, and so could, if viewed at smaller angles, explain the extreme variability properties of those objects.Comment: 4 pages, 3 figures, ApJ Lett., in pres

Budget Processes: Theory and Experimental Evidence

This paper studies budget processes, both theoretically and experimentally. We compare the outcomes of bottom-up and top-down budget processes. It is often presumed that a top-down budget process leads to a smaller overall budget than a bottom-up budget process. Ferejohn and Krehbiel (1987) showed theoretically that this need not be the case. We test experimentally the theoretical predictions of their work. The evidence from these experiments lends strong support to their theory, both at the aggregate and the individual subject level

Verbal labeling, rehearsal, and short-term memory

The effects of verbal labeling in a serial position short-term memory (STM) task were investigated in two studies. In the first, 32 children at each of the grades 4, 6, and 8 were tested. In the second, 40 college students were tested. The stimuli consisted of eight cards with a central and an incidental picture on each. Half of the subjects overtly labeled the central pictures as they were presented; half did not. In Study I there were eight trials; in Study II there were additional trials in which stimuli contained only the central pictures. In Study I labeling did not affect overall performance; in Study II labeling was found to decrease performance significantly. For both studies labeling had differential effects at the primacy and recency portions of the serial-position data. There was no effect of one versus two stimuli per card in Study II. The findings were discussed in terms of issues concerning verbal mediation and rehearsal strategies. A developmental model for the processes involved in serial-position STM was presented.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32831/1/0000206.pd

Labeling, rehearsal, and short-term memory in retarded children

A short-term memory task was used to explore the effects of verbal labeling and rehearsal on serial-position recall in mildly retarded 9- to 11-year-old children. A stimulus array consisting of seven cards depicting familiar animals was presented for seven trials. In Expt I, recall when subjects labeled the pictures as they were shown was compared to recall when no labeling occurred. Total recall was not affected, but for the older CA group primacy recall was hindered and recency recall was facilitated by labeling. In Expt II, three variations of rehearsal of the names to be recalled were compared. When prompting accompanied rehearsal, recall improved at both recency and primacy positions. When prompting occurred for the primacy positions only, recall was higher for these positions but not for other positions. These results support the view that verbal skills affect recall in mildly retarded children similarly to normal children.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/22264/1/0000701.pd

The Lyman Alpha Reference Sample. VIII. Characterizing Lyman-Alpha Scattering in Nearby Galaxies

We examine the dust geometry and Ly{\alpha} scattering in the galaxies of the Lyman Alpha Reference Sample (LARS), a set of 14 nearby (0.02 < $z$ < 0.2) Ly{\alpha} emitting and starbursting systems with Hubble Space Telescope Ly{\alpha}, H{\alpha}, and H{\beta} imaging. We find that the global dust properties determined by line ratios are consistent with other studies, with some of the LARS galaxies exhibiting clumpy dust media while others of them show significantly lower Ly{\alpha} emission compared to their Balmer decrement. With the LARS imaging, we present Ly{\alpha}/H{\alpha} and H{\alpha}/H{\beta} maps with spatial resolutions as low as $\sim$ 40 pc, and use these data to show that in most galaxies, the dust geometry is best modeled by three distinct regions: a central core where dust acts as a screen, an annulus where dust is distributed in clumps, and an outer envelope where Ly{\alpha} photons only scatter. We show that the dust that affects the escape of Ly{\alpha} is more restricted to the galaxies' central regions, while the larger Ly{\alpha} halos are generated by scattering at large radii. We present an empirical modeling technique to quantify how much Ly{\alpha} scatters in the halo, and find that this "characteristic" scattering distance correlates with the measured size of the Ly{\alpha} halo. We note that there exists a slight anti-correlation between the scattering distance of Ly{\alpha} and global dust properties.Comment: 32 pages, 51 figures, accepted to Ap

A meta-analysis of greater sage-grouse Centrocercus urophasianus nesting and brood rearing habitat

The distribution and range of the greater sage-grouse Centrocercus urophasianus have been reduced by 56% since the European settlement of western North America. Although there is an unprecedented effort to conserve the species, there is still considerable debate about the vegetation composition and structure required for nesting and brood-rearing habitat. We conducted a meta-analysis of vegetation characteristics recorded in studies at nest sites (N  =  24) and brood habitats (N  =  8) to determine if there was an overall effect (Hedge's d) of habitat selection and to estimate average canopy cover of sagebrush Artemisia spp., grass and forbs, and also height of grass at nest sites and brood-rearing areas. We estimated effect sizes from the difference between use (nests and brood areas) and random sampling points for each study, and derived an overall effect size across all studies. Sagebrush cover (d₊₊  =  0.39; 95% C.I.: 0.19-0.54) and grass height (d₊₊ =  0.28; 95% C.I.: 0.13-0.42) were greater at nest sites than at random locations. Vegetation at brood areas had less sagebrush cover (d₊₊  =  -0.17; 95% C.I.: -0.44 - +0.18), significantly taller grasses (d₊₊  =  0.31; 95% C.I.: 0.14-0.45), greater forb (d₊₊  =  0.48; 95% C.I.: 0.30-0.67) and grass cover (d₊₊ =  0.17; 95% C.I.: 0.08-0.27) than at random locations. These patterns were especially evident when we examined early (< 6 weeks post hatching) and late brood-rearing habitats separately. The overall estimates of nest and brood area vegetation variables were consistent with those provided in published guidelines for the management of greater sage-grouse.Keywords: sagebrush, breeding habitat, effect size, greater sage-grouse, Artemisia spp., Hedges’ d, meta-analysi

Measurement of the Condensation Coefficient of Water in the UMR Cloud Simulation Chamber

Measurements of the condensation coefficient of water under conditions closely approximating those in natural atmospheric cloud have been made in the cooled-wall UMR cloud simulation chamber. Current measurements disclose a value of condensation coefficient near unity at the outset of the experiment, generally decreasing to lower values (~ .01) as the experiment progresses. The significance of the magnitude of condensation coefficient in atmospheric cloud is briefly discussed