Buttressing staples with cholecyst-derived extracellular matrix (CEM) reinforces staple lines in an ex vivo peristaltic inflation model

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ Springer Science + Business Media, LLC 2008Background - Staple line leakage and bleeding are the most common problems associated with the use of surgical staplers for gastrointestinal resection and anastomotic procedures. These complications can be reduced by reinforcing the staple lines with buttressing materials. The current study reports the potential use of cholecyst-derived extracellular matrix (CEM) in non-crosslinked (NCEM) and crosslinked (XCEM) forms, and compares their mechanical performance with clinically available buttress materials [small intestinal submucosa (SIS) and bovine pericardium (BP)] in an ex vivo small intestine model. Methods - Three crosslinked CEM variants (XCEM0005, XCEM001, and XCEM0033) with different degree of crosslinking were produced. An ex vivo peristaltic inflation model was established. Porcine small intestine segments were stapled on one end, using buttressed or non-buttressed surgical staplers. The opened, non-stapled ends were connected to a peristaltic pump and pressure transducer and sealed. The staple lines were then exposed to increased intraluminal pressure in a peristaltic manner. Both the leak and burst pressures of the test specimens were recorded. Results - The leak pressures observed for non-crosslinked NCEM (137.8 ± 22.3 mmHg), crosslinked XCEM0005 (109.1 ± 14.1 mmHg), XCEM001 (150.1 ± 16.0 mmHg), XCEM0033 (98.8 ± 10.5 mmHg) reinforced staple lines were significantly higher when compared to non-buttressed control (28.3 ± 10.8 mmHg) and SIS (one and four layers) (62.6 ± 11.8 and 57.6 ± 12.3 mmHg, respectively) buttressed staple lines. NCEM and XCEM were comparable to that observed for BP buttressed staple lines (138.8 ± 3.6 mmHg). Only specimens with reinforced staple lines were able to achieve high intraluminal pressures (ruptured at the intestinal mesentery), indicating that buttress reinforcements were able to withstand pressure higher than that of natural tissue (physiological failure). Conclusions - These findings suggest that the use of CEM and XCEM as buttressing materials is associated with reinforced staple lines and increased leak pressures when compared to non-buttressed staple lines. CEM and XCEM were found to perform comparably with clinically available buttress materials in this ex vivo model.Enterprise Irelan

Past Tense Route Priming

The current study examined whether lexical: whole word) or more rule-based: morphological constituent) processes can be locally biased by experimental list context in past tense verb inflection in younger and older adults. During each trial, participants produced the past tense verb from a present tense verb. List context was manipulated across blocks such that context trials consisted of either regular past tense verbs: e.g., LIVE-LIVED) or irregular past tense verbs: e.g., RUN-RAN). Half of the targets within each list context were regular and half were irregular verbs. In the regular context, there was a very robust regularity effect: regular targets verbs were conjugated faster and more accurately than irregular target verbs. In the irregular context, this regularity effect was reversed in response times and diminished in accuracy. Age group and individual difference measures of attention and vocabulary were also investigated as possible variables that may modulate the route priming effects. The results support the notion that distinct processes in past tense verb production can be locally biased by list context

The Influence of Word Frequency and Aging on Lexical Access

Visual word recognition has been a central area of psychological inquiry over the past century. The current dissertation examines how visual word recognition changes as a function of age by focusing on the influence of word frequency, or how commonly a word is encountered. Word frequency is arguably the strongest predictor of visual word recognition performance across a variety of language tasks, and the most influential factor in models of language processing. All models of visual word recognition include a strong role for word frequency but often assume different underlying mechanisms, which produce differing predictions for age changes. Although there is already a literature examining word frequency effects in younger and older adults, these studies have produced inconsistent results, possibly due to procedural limitations and task-specific processes. This dissertation explores the influence of task and age on the word frequency effect, while directly examining individual differences (e.g., changes in vocabulary, vision, education) in order to better understand the mechanisms underlying word frequency effects. In contrast to the dichotomous approach of examining extreme groups of young and older adults, or extreme bands of word frequency, the present study examined both variables in a continuous manner. The primary finding is that the word frequency effect does not appear to change as a function of age across all three tasks considered. This finding is discussed in reference to previous inconsistent findings in the literature and important theoretical implications

Physics and Applications of Laser Diode Chaos

An overview of chaos in laser diodes is provided which surveys experimental achievements in the area and explains the theory behind the phenomenon. The fundamental physics underpinning this behaviour and also the opportunities for harnessing laser diode chaos for potential applications are discussed. The availability and ease of operation of laser diodes, in a wide range of configurations, make them a convenient test-bed for exploring basic aspects of nonlinear and chaotic dynamics. It also makes them attractive for practical tasks, such as chaos-based secure communications and random number generation. Avenues for future research and development of chaotic laser diodes are also identified.Comment: Published in Nature Photonic

Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus

Bariatric surgery; Consensus; Metabolic surgeryCirugía bariátrica; Consenso; Cirugía metabólicaCirurgia bariàtrica; Consens; Cirurgia metabòlicaMetabolic and bariatric surgery (MBS) is widely considered the most effective option for treating obesity, a chronic, relapsing, and progressive disease. Recently, the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) issued new guidelines on the indications for MBS, which have superseded the previous 1991 National Institutes of Health guidelines. The aim of this study is to establish the first set of consensus guidelines for selecting procedures in Class I and II obesity, using an Expert Modified Delphi Method. In this study, 78 experienced bariatric surgeons from 32 countries participated in a two-round Modified Delphi consensus voting process. The threshold for consensus was set at an agreement or disagreement of ≥ 70.0% among the experts. The experts reached a consensus on 54 statements. The committee of experts reached a consensus that MBS is a cost-effective treatment option for Class II obesity and for patients with Class I obesity who have not achieved significant weight loss through non-surgical methods. MBS was also considered suitable for patients with Type 2 diabetes mellitus (T2DM) and a body mass index (BMI) of 30 kg/m2 or higher. The committee identified intra-gastric balloon (IGB) as a treatment option for patients with class I obesity and endoscopic sleeve gastroplasty (ESG) as an option for patients with class I and II obesity, as well as for patients with T2DM and a BMI of ≥ 30 kg/m2. Sleeve gastrectomy (1) and Roux-en-Y gastric bypass (RYGB) were also recognized as viable treatment options for these patient groups. The committee also agreed that one anastomosis gastric bypass (OAGB) is a suitable option for patients with Class II obesity and T2DM, regardless of the presence or severity of obesity-related medical problems. The recommendations for selecting procedures in Class I and II obesity, developed through an Expert Modified Delphi Consensus, suggest that the use of standard primary bariatric endoscopic (IGB, ESG) and surgical procedures (SG, RYGB, OAGB) are acceptable in these patient groups, as consensus was reached regarding these procedures. However, randomized controlled trials are still needed in Class I and II Obesity to identify the best treatment approach for these patients in the future

Past tense route priming

a b s t r a c t The present research examined whether lexical (whole word) or more rule-based (morphological constituent) processes can be locally biased by experimental list context in past tense verb inflection. In Experiment 1, younger and older adults completed a past tense inflection task in which list context was manipulated across blocks containing regular past tense verbs (e.g. REACH-REACHED) or irregular past tense verbs (TEACH-TAUGHT). Critical targets, consisting of half regular and half irregular verbs, were embedded within blocks and participants' inflection response latency and accuracy were assessed. The results yielded a cross-over interaction in response latencies for both young and older adults. In the regular context there was a robust regularity effect: regular target verbs were conjugated faster than irregular target verbs. In contrast, in the irregular context, irregular target verbs were conjugated faster than regular target verbs. Experiment 2 used the same targets but in the context of either standard nonwords or nonwords ending in ''-ED'' to test the possibility of a phonological basis for the effect. The effect of context was eliminated. The results support the notion that distinct processes in past tense verb production can be locally biased by list context and, as shown in Experiment 2, this route priming effect was not due to phonological priming

Evaluation of the Efficacy of Single Anastomosis Sleeve Ileal (SASI) Bypass for Patients with Morbid Obesity: a Multicenter Study

Background: Single anastomosis sleeve ileal (SASI) bypass is a newly introduced bariatric and metabolic procedure. The present multicenter study aimed to evaluate the efficacy of the SASI bypass in the treatment of patients with morbid obesity and the metabolic syndrome. Methods: This is a retrospective, seven-country, multicenter study on patients with morbid obesity who underwent the SASI bypass. Data regarding patients' demographics, body mass index (BMI), percentage of total weight loss (%TWL), percentage of excess weight loss (%EWL), and improvement in comorbidities at 12 months postoperatively and postoperative complications were collected. Results: Among 605 patients who underwent the SASI, 54 were excluded and 551 (390; 70.8% female) were included. At 12 months after the SASI, a significant decrease in the BMI was observed (43.2 ± 12.5 to 31.2 ± 9.7 kg/m2; p < 0.0001). The %TWL was 27.4 ± 13.4 and the %EWL was 63.9 ± 29.5. Among the 279 patients with type 2 diabetes mellitus (T2DM), complete remission was recorded in 234 (83.9%) patients and partial improvement in 43 (15.4%) patients. Eighty-six (36.1%) patients with hypertension, 104 (65%) patients with hyperlipidemia, 37 (57.8%) patients with sleep apnea, and 70 (92.1%) patients with GERD achieved remission. Fifty-six (10.1%) complications and 2 (0.3%) mortalities were recorded. Most complications were minor. All patients had 12 months follow-up. Conclusions: The SASI bypass is an effective bariatric and metabolic surgery that achieved satisfactory weight loss and improvement in medical comorbidities, including T2DM, hypertension, sleep apnea, and GERD, with a low complication rate.info:eu-repo/semantics/publishedVersio

IFSO Worldwide Survey 2020-2021: Current Trends for Bariatric and Metabolic Procedures

PURPOSE This IFSO survey aims to describe the current trends of metabolic and bariatric surgery (MBS) reporting on the number and types of surgical and endoluminal procedures performed in 2020 and 2021, in the world and within each IFSO chapter. METHODS All national societies belonging to IFSO were asked to complete the survey form. The number and types of procedures performed (surgical and endoluminal interventions) from 2020 to 2021 were documented. A special section focused on the impact of COVID-19, the existence of national protocols for MBS, the use of telemedicine, and any mortality related to MBS. A trend analysis of the data, both worldwide and within each IFSO chapter, was also performed for the period between 2018 and 2021. RESULTS Fifty-seven of the 74 (77%) IFSO national societies submitted the survey. Twenty-four of the 57 (42.1%) reported data from their national registries. The total number of surgical and endoluminal procedures performed in 2020 was 507,806 and in 2021 was 598,834. Sleeve gastrectomy (SG) remained the most performed bariatric procedure. Thirty national societies (52%) had regional protocols for MBS during COVID-19, 61.4% supported the use of telemedicine, and only 47.3% collected data on mortality after MBS in 2020. These percentages did not significantly change in 2021 (p > 0.05). CONCLUSIONS The number of MBS markedly decreased worldwide during 2020. Although there was a positive trend in 2021, it did not reach the values obtained before the COVID-19 pandemic. SG continued to be the most performed operation. Adjustable gastric banding (AGB) continues to decrease worldwide

The past tense inflection project (PTIP): speeded past tense inflections, imageability ratings, and past tense consistency measures for 2,200 verbs

Abstract The processes involved in past tense verb generation have been central to models of inflectional morphology. However, the empirical support for such models has often been based on studies of accuracy in past tense verb formation on a relatively small set of items. We present the first largescale study of past tense inflection (the Past Tense Inflection Project, or PTIP) that affords response time, accuracy, and error analyses in the generation of the past tense form from the present tense form for over 2,000 verbs. In addition to standard lexical variables (such as word frequency, length, and orthographic and phonological neighborhood), we have also developed new measures of past tense neighborhood consistency and verb imageability for these stimuli, and via regression analyses we demonstrate the utility of these new measures in predicting past tense verb generation. The PTIP can be used to further evaluate existing models, to provide well controlled stimuli for new studies, and to uncover novel theoretical principles in past tense morphology. Keywords Verb processing . Megastudy . Past tense inflection . Item-level variance . Verb consistency . Verb imageability A long-standing question in language acquisition and inflectional morphology is how individuals produce the past tense form of a verb. Past tense inflection (PTI), like spelling-to-sound conversion in English, is quasiregular, meaning that a set of generally applicable descriptive rules are useful for most verbs (e.g., add -ed to the stem form), but there are also some irregular forms (e.g., dodid) and subregularities (as in the eep-ept past tense family: sleep-slept, weep-wept, keep-kept, etc.). Indeed, past tense inflection has been a central focus of the debate between parallel distributed models Although there has been extensive theoretical work in the area of past tense verb generation, experimental work examining response times (RTs) has been relatively limited. For example, in the stem inflection task, participants are asked to produce the past tense (real or hypothetical) of a target verb or novel nonword (e.g., Only a few previous studies of past tense verb inflection have used RT as a dependent variable: Joanisse and Seidenberg One way to address the discrepancies among previous studies, as well as the limitations associated with factorial designs employing relatively few stimuli, is to sample a much larger set of items from the language. Megastudies include stimuli on the order of thousands, rather than 50 to 100, and allow for the effects of variables to be modeled continuously rather than categorically (see In addition to providing a large database of response latencies and accuracies for past tense verb inflection, we also developed two new measures that are important to consider in past tense inflection, consistency and imageability. Similar to the spelling-to-sound consistency measure that has been well-studied in visual word recognition research The second variable that we measured was imageability. Imageability is a variable that reflects the extent to which 152 Behav Res (2013) 45:151-159 one is able to form a mental image of a word, and indeed many imageability norms are already available (e.g., The present study is based on 89 participants&apos; accuracy and RTs for a past tense inflection task with 2,200 verbs. Each participant produced responses to 888 items. For each verb in the PTIP database, we included measures of RT, accuracy, and regularization errors (e.g., saying GRINDED for GRIND), along with the new imageability and consistency measures described above. The PTIP database is useful in examining the specific effects of predictor variables on RT and accuracy and allows for detailed item-level predictions. It is available as supplementary materials with this article for researchers who plan to examine other theoretical questions about past tense inflection, or are hoping to select well-controlled and well-examined stimuli for new studies. These data will serve as both a reference and an impetus for further research in the domain of past tense inflection. Experiment 1 The first experiment was conducted in order to collect imageability rating norms for the verbs in the PTIP database. Method Participants A group of 218 participants were recruited via Amazon&apos;s Mechanical Turk (AMT; see Materials The 2,200 words from the PTIP database (see below), plus another 112 words for use in another study, were divided into eight lists of 289 items each. The eight lists were presented as separate jobs in AMT. Procedure Each participant completed one list of the rating task, which was presented in Adobe Flash and appeared after a consent screen in the AMT job description. The instructions were the same as those used in Results The ratings were aggregated across participants for each item (excluding &quot;do not know&quot; responses), so that one mean imageability value was calculated for each verb. These values were used in Experiment 2 (see below). The mean rating across all verbs was 4.28 (SD 0 0.92), and the mean RT across all verbs was 3,191 ms (SD 0 1,695). The overall split-half reliability was r 0 .80, p &lt; .001. Experiment 2 Method Participants A group of 113 native English-speaking college students from the Washington University subject pool participated in Behav Res (2013) 45:151-159 153 the study. After eliminating extreme outliers (less than 80 % accuracy overall; four participants) or participants whose data were subject to recording error (missing sound files from which to code accuracy-20 participants), 89 participants contributed to the final database