Comparing the excessive daytime sleepiness of obese and non-obese patients

Background: Obesity, particularly morbid obesity, has various physical and mental complications. Excessive daytime somnolence (EDS) is a sleep disorder that reduces individuals� performance capability and the accuracy of their short-term memory and causes learning problems. This retrospective study aimed to document the presence of EDS in a sample of obese patients in comparison to patients with a normal weight. Objectives: This article compares the excessive daytime sleepiness of obese and non-obese patients in the minimally invasive surgery research center in Tehran, Iran. Patients and Methods: In this case-control study, we compared excessive daytime sleepiness in 55 obese patients who were candidates for laparoscopic surgery, with a body mass index (BMI) of equal to or greater than 30 kg/m2, with 55 controls with a normal BMI (19.5-24.9 kg/m2). The process of selecting the control group in our case-control study is matching in group levels, so that the controls are similar to the case group with regard to certain key characteristics, such as age, sex, and race. The sleep assessment was based on the Epworth sleepiness scale (ESS) questionnaire. Analysis of variance (ANOVA) was used to compare the means of quantitative data, such as the ESS score of groups. Results: Sleepiness was not affected by gender in cases or controls. The sleepiness prevalence was 29 (52.7) in the cases group and 17 (30.9) in the control group (OR = 2.493 (95 CI 1.144-5.435)). The mean ESS scores in cases and controls were 7.82 ± 3.86 and 10.54±6.15, respectively (P = 0.007). Moreover, the prevalence of sleepiness and the mean ESS scores in class III of obesity differed significantly from the controls (16 (57.1) vs. 17 (30.9)) (OR = 2.980 (95 CI 1.162-7.645)) and (11.04±5.93 vs. 7.82±3.86) (P = 0.013), respectively. Conclusions: Our findings suggest a strong relationship between EDS and obesity, particularly morbid obesity. Therefore, physicians must be familiar with EDS as a mixed clinical entity indicating careful assessment and specific treatment planning. © 2016, Iranian Red Crescent Medical Journal

Bariatric Surgical Practice During the Initial Phase of COVID-19 Outbreak

There is no data on patients with severe obesity who developed coronavirus disease 2019 (COVID-19) after bariatric surgery. Four gastric bypass operations, performed in a 2-week period between Feb 24 and March 4, 2020, in Tehran, Iran, were complicated with COVID-19. The mean age and body mass index were 46 ± 12 years and 49 ± 3 kg/m2. Patients developed their symptoms (fever, cough, dyspnea, and fatigue) 1, 2, 4, and 14 days after surgery. One patient had unnoticed anosmia 2 days before surgery. Three patients were readmitted in hospital. All 4 patients were treated with hydroxychloroquine. In two patients who required admission in intensive care unit, other off-label therapies including antiretroviral and immunosuppressive agents were also administered. All patients survived. In conclusion, COVID-19 can complicate the postoperative course of patients after bariatric surgery. Correct diagnosis and management in the postoperative setting would be challenging. Timing of infection after surgery in our series would raise the possibility of hospital transmission of COVID-19: from asymptomatic patients at the time of bariatric surgery to the healthcare workers versus acquiring the COVID-19 infection by non-infected patients in the perioperative period. © 2020, Springer Science+Business Media, LLC, part of Springer Nature

Action Recognition with a Bio--Inspired Feedforward Motion Processing Model: The Richness of Center-Surround Interactions

International audienceHere we show that reproducing the functional properties of MT cells with various center--surround interactions enriches motion representation and improves the action recognition performance. To do so, we propose a simplified bio--inspired model of the motion pathway in primates: It is a feedforward model restricted to V1-MT cortical layers, cortical cells cover the visual space with a foveated structure, and more importantly, we reproduce some of the richness of center-surround interactions of MT cells. Interestingly, as observed in neurophysiology, our MT cells not only behave like simple velocity detectors, but also respond to several kinds of motion contrasts. Results show that this diversity of motion representation at the MT level is a major advantage for an action recognition task. Defining motion maps as our feature vectors, we used a standard classification method on the Weizmann database: We obtained an average recognition rate of 98.9%, which is superior to the recent results by Jhuang et al. (2007). These promising results encourage us to further develop bio--inspired models incorporating other brain mechanisms and cortical layers in order to deal with more complex videos

Improving employee outcome through human resource management practices and public service motivation: a study of Malaysia public sector

The purpose of this paper is to examine the relationship between Human Resource Management (HRM) practices and Public Service Motivation (PSM) and its impact on the employee outcome. The proposed framework intends to add to the understanding of specific process that mediate between HRM practices and employee outcome in Malaysia public sector. This study is based on reviews of prior studies and theories on HRM practices, employee outcome and PSM. A conceptual framework is provided with the objective to measure HRM practices-employee outcome relationship with the mediation of PSM. This paper proposes to answer how HRM practices can influence employee outcome through the mediating factor of PSM in public sector of Malaysia. This paper can assist the HR managers to understand on the significance of motivation serving the public as the mediating variable and the way HRM practices, through the integration of these two processes lead to the enhancement of employee outcome of becoming 1st class public servants. This paper attempt to clarify the linking process through which HRM practices influence employee outcome. Hopefully, the conceptual framework proposed can contribute further towards the body of literatures since there are still no definite answers of the connection between HRM practices and employee outcome. It can be used for further empirical test in Malaysia public sector

Persistent Paraplegia After Sleeve Gastrectomy: a Case Report

Neurological complications secondary to weight loss surgery (WLS) are highly reported and include peripheral nerve injury, Wernicke�s encephalopathy, polyradiculoneuropathy, neuropathy, myelopathy, peripheral neuropathy, and myopathy. Neurological complications may result from mechanical or inflammatory mechanisms, but they result mainly from deficiencies in B vitamins, vitamin D, vitamin E, zinc, and copper occurring in WLS. Herein is reported the case of a 25-year-old woman with complaints of paraplegia after a sleeve gastrectomy probably due to nutritional deficiencies. This case illustrates the necessity for medical nutrition therapy (MNT) before and after bariatric surgery. © 2020, Association of Surgeons of India