Mean Total Length Research Articles

Precise Thoracoscopic Pneumonectomy Using Fluorescence Imaging After Aerosolized Indocyanine Green Inhalation: A Novel Strategy for Treating Congenital Pulmonary Airway Malformation

BackgroundLobectomy resection is the standard treatment for patients with congenital pulmonary airway malformation (CPAM). However, accurate localization of CPAM lesions and avoiding excessive resection of normal lung tissue are one of the critical issues that can impact postoperative pulmonary function. Indocyanine green (ICG) can be adopted in lung preservation surgery, to minimize damage to normal lung tissue during thoracoscopic pneumonectomy. ObjectiveTo demonstrate the potential benefits of aerosol inhalation of ICG followed by thoracoscopic precision pneumonectomy for the treatment of CPAM. MethodsFrom January 2023 to March 2024, we prospectively collected clinical data from 34 pediatric patients diagnosed with CPAM and treated with thoracoscopic surgery. Patients inhaled ICG aerosol solution (0.5 mg/kg) approximately 30-60 minutes before the operation. During surgery, fluorescence thoracoscopy was used to clearly locate the lesion boundaries and achieve precise resection. ResultsAll patients successfully underwent thoracoscopic precise resection of CPAM lesions without conversion to open surgery. The mean operation time was 100.3 ± 24.6 minutes, and the mean intraoperative blood loss was 30.5 ± 25.6 mL. The mean total length of hospital stay (tLOS) was 6.6 ± 3.2 days. No adverse reactions to ICG were observed. Postoperative complications included one case of pneumothorax (5.9%) and three cases of subcutaneous emphysema (17.6%), all of which resolved without special intervention. Follow-up CT scans and pulmonary function tests conducted 6 months post-surgery demonstrated the absence of residual or recurrent lesions and notable enhancement in pulmonary function. ConclusionPreliminary results indicated that the treatment of CPAM with aerosolized ICG followed by thoracoscopic precise pneumonectomy is safe and feasible.

Impact of an Enhanced Recovery After Surgery (ERAS) program on the management of complications after laparoscopic or robotic colectomy for cancer.

Enhanced Recovery After Surgery (ERAS) reduces postoperative complications (POCs) after colorectal surgery; however, its impact on the management of POCs remains unclear. This study compared the diagnosis and management of POCs before and after implementing our ERAS protocol after laparoscopic or robotic colectomy for cancer and examined the short- and mid-term oncologic impacts. This single-center, retrospective study evaluated all consecutive patients who underwent laparoscopic or robotic colectomy for cancer between 2012 and 2021, focusing on the incidence of POCs within 90 days. We compared outcomes before (standard group) and after (ERAS group) the implementation of our ERAS protocol in January 2016. Significantly fewer patients in the ERAS group developed POCs (standard vs. ERAS, 136 of 380 patients [35.8%] vs.136 of 660 patients [20.6%]; P<0.01). The ERAS group had a significantly shorter mean total length of stay after POCs (13.1 days vs. 11.4 days, P=0.04), and the rates of life-threatening complications (6.7% vs. 0.7%) and 1-year mortality (7.4% vs. 1.5%) were significantly lower in the ERAS group than in the standard group. Among patients with anastomotic complications, laparoscopic reoperation was significantly more common in the ERAS group than in the standard group (8.3% vs. 75.0%, P<0.01). Among patients with postoperative ileus, the diagnosis and recovery times were significantly shorter in the ERAS group than in the standard group, resulting in a shorter total length of stay (13.5 days vs. 10 days, P<0.01). The implementation of an ERAS protocol did not eliminate all POCs, but it did accelerate their diagnosis and management and improved patient outcomes.

Diet and biological characteristics of Atlantic Tomcod or Punamu, Microgadus tomcod (Walbaum, 1792) in Minas Basin, Nova Scotia

Atlantic tomcod are abundant in the Bay of Fundy, but their diet is unreported for Minas Basin. In this study prey content and biological characteristics of tomcod collected in the Avon River estuary of Minas Basin were examined. Their diet was numerically dominated by the amphipod Corophium volutator (Pallas, 1766) (Rate of Occurrence (RO) = 73.2%). Other major prey taxa consumed included Crangon septemspinosa Say, 1818 (29.3%), Gammarus spp. (19.5%), Polychaeta (14.6%), Portunidae (12.2%), Teleostei (9.8%), Isopoda (7.3%), andMollusca (3.3%). Of stomachs examined only 8.9% contained unidentifiable prey items. Every tomcod examined except one contained prey and the fullness index (HI) varied between 0.01-5.85%. Both mean total length and total body weight of females was significantly greater than for males (254 mm vs 202 mm; 143 g vs 78 g), and the condition factor (K) of both sexes was similar throughout the sampling period (Mean ± SD; 0.79 ± 0.13). Both mean male and female gonadosomatic index (GSI) increased significantly when approaching the winter spawning period, rising from 1.2 in early October to 11.6 by mid-December.The diversity of prey consumed indicated that tomcod fed opportunis-tically, but their predominate consumption of C. volutator was likely linked to the large populations of this amphipod on the intertidal mudflats of Minas Basin. Keywords: Atlantic tomcod, Bay of Fundy, condition factor, Corophium volutator, fullness index, gonadosomatic index

Exploring Recidivism in Cardiac Surgical ICU: Can this Understanding Translate to Enhanced Patient Outcomes?

The need for reinstitution of intensive care unit (ICU) care ("recidivism") in post-cardiac surgery patients is associated with increased morbidity, mortality, resource use, and healthcare costs. Recidivism is propounded as a quality indicator of ICU care. There is a paucity of studies from India regarding cardiac surgical ICU readmissions, their outcomes, and risk factors. Nested case-control study including 1,711 consecutive adult patients who underwent cardiac surgery over a two-year period at a tertiary care institute. The patients were grouped into recidival (R) and control (C) groups. The reasons for readmission, outcomes, and predictive risk factors were analyzed. Fifty-four of 1,711 (3.1%) patients were readmitted to ICU, main reasons being cardiac arrhythmias (24, 41%), pericardial effusion (9, 15.2%), and infection (8, 13.5%). Readmission was significantly higher for valvular interventions (39 patients, 24.3%, mitral valve 25 patients) than coronary artery bypass grafting (13, 10.6%), P value 0.003*. On multivariate analysis, EuroSCORE 2 (>5), age, surgical reexploration, postoperative pulmonary complications, and infections were independently associated with a need for ICU readmission. The mortality rate among the readmitted patients was 7.4% compared to 1.4% overall mortality. The mean total postoperative length of stay was significantly longer for recidival patients (17.6 ± 14 days vs 7.6 ± 2.4 days; P < 0.0001). Recidivism is associated with longer hospital stay, suboptimal outcomes as well higher risk of mortality. Postoperative cardiac dysrhythmia was the most common cause of recidivism in our cohort. Early identification of patients at risk for recidivism and timely management of cardiopulmonary complications can translate to better outcomes.

Outcomes of patients with cancer cared for in a multisite home hospital program.

394 Background: Home hospital provides hospital-level care for acutely ill patients in their homes as a substitute for care in brick-and-mortar hospitals. Since the Centers for Medicare and Medicaid Services’ acute hospital care at home waiver in November 2020, 330 hospitals have received approval to launch home hospital programs. Prior research has shown that patients cared for in home hospital have improved physical activity, and lower mortality and readmission rates. However, many of these programs exclude patients with cancer, and data describing outcomes of patients with cancer cared for in home hospital programs are limited. Methods: We identified patients admitted to a multisite home hospital program affiliated with an urban health system between February 1, 2020 and May 1, 2024 who had a diagnosis of cancer (ICD-10: C00-C96) or myelodysplastic syndrome (ICD-10: D46) managed by an oncologist within the health system. For each admission we conducted chart reviews to determine whether the malignancy was active at the time of admission, defined by ongoing antineoplastic treatment or an admission directly related to the malignancy. We also captured the patient’s cancer diagnosis, the admission diagnosis, total length of stay, and length of time in home hospital. We identified readmissions within 30 days of discharge and escalations of care, defined as a return to a brick-and-mortar hospital for additional care spanning at least one midnight, and calculated rates of these outcomes. Results: There were 141 home hospital admissions among 128 patients with cancer diagnoses (mean age: 77, 36% female). The most common oncologic diagnoses were lymphoma (16%, N = 22), chronic leukemias and MDS (14%, N = 20), and lung cancer (13%, N = 18). Seventy-one patients (50%) had active cancer at the time of admission. The leading admission diagnoses were pneumonia (N = 28, 16%), heart failure exacerbations (N = 19, 13%), complicated urinary tract infections (N = 12, 9%) and soft tissue infections (N = 10, 7%). The mean total length of stay was 7.9 days (SD 5.6) and patients were admitted to home hospital for a mean of 4.9 days (SD: 3.5). Escalation rates and 30-day readmission rates were 7% (N = 10) and 13% (N = 19), respectively, among all patients, and 5% (N = 4) and 14% (N = 10) among patients with active malignancies. Conclusions: These data describe a cohort of patients with cancer cared for in a multisite home hospital program. They show low rates of transfer back to brick-and-mortar hospitals and low 30-day readmission rates, and they demonstrate that patients with cancer can be safely cared for in a home hospital. As home hospital programs build new capabilities, a larger proportion of oncology patients will be eligible for home hospital. More work is needed to estimate risk-adjusted outcomes among these populations and to understand the patient and caregiver experience with oncology home hospital.

Clinical and Angiographic Profile of Non-ST Elevation Myocardial Infarction Patients with Multivessel Disease: A Study in a Tertiary Care Hospital in Bangladesh

Background: Non-ST elevation myocardial infarction (NSTEMI) is a type of acute coronary syndrome without ST-segment elevation on electrocardiography. Many non-ST elevation myocardial infarction patients have multivessel disease, which leads to worse outcomes compared to single-vessel disease. Their clinical and angiographic profiles provide valuable insightf into the nature, severity, and treatment of this common cardiac condition. This study aimed to evaluate the clinical and angiographic profiles of non-ST elevation myocardial infarction patients with multivessel disease. Methods: This prospective study was conducted in the Department of Cardiology, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh from September 2022 to August 2023. The study enrolled 270 consecutive patients with NSTEMI. Coronary angiography and electrocardiogram were used in assessing the disease condition. The data were analyzed using SPSS version 23.0. Results: The mean age of total participants was 54.31 ±10.54 years and most of them were male (77.8%). Majority of the patients had hypertension (68.1%), diabetes mellitus (59.3%), and dyslipidemia (58.5%). In the clinical assessment, 89.6% of patients had femoral access, 31.1% had a bifurcation lesion, 8.1% showed calcification, and 22.6% had a left main lesion. Stents were used in 41.9% of cases, with a mean total stent length of 55.8 ±26.9 mm. The mean left ventricular ejection fraction was 49.10 ±7.3%. Among the major culprit vessel involvements identified, 6% involved the left main (LM) artery, 56% involved the left anterior descending (LAD) artery, 34% involved the left circumflex (LCX) artery, and 39% involved the right coronary artery (RCA). Regarding the final angiographic findings among the total participants, double vessel disease (DVD) was observed in 40% of cases, while triple vessel disease was observed in 60% of cases. Conclusion: The increased prevalence of triple vessel disease among non-ST elevation myocardial infarction patients underscores the importance of heightened vigilance among healthcare providers and policymakers. Understanding the clinical and angiographic profiles of these patients is essential for effective management strategies.

Standard length of peroral endoscopic myotomy (POEM) for achalasia: a systematic review and meta-analysis.

Peroral endoscopic myotomy (POEM) is an established treatment for achalasia, yet there is still a lack of technical standardization. No clear definition of 'long', 'standard', or 'short' POEM exists to date. We conducted a systematic review with meta-analysis to analyze current POEM length standards. We included studies reporting technical details of POEM, in which no definite or comparative myotomy length was intentionally adopted (standard myotomy). The primary outcome was the pooled mean total myotomy length. Sub-group analyses were performed to explore heterogeneity across studies. From the initial 7172 records, 31 studies with 3023 patients were included. Pooled mean of total myotomy length was 10.39cm (95% CI 10.06-10.71; I2 99.3%). Pooled mean of esophageal and gastric myotomy length, provided by 17 studies, was 7.11cm (95% CI 6.51-7.71; I2 99.8%) and 2.81cm (95% CI 2.41-3-22; I2 99.8%), respectively. On subgroup analysis for achalasia subtypes, pooled mean length in non-spastic achalasia (type I and II) was 10.17cm (95% CI 9.91-10.43; I2 94.2%), while in type III it was 14.02cm (95% CI 10.59-17.44; I2 98.9%). Pooled mean myotomy length for studies conducted between 2014-2020 was 10.53cm (95% CI, 10.22-10.84; I2 99.1%) and 9.74cm (95% CI, 7.95-11.54; I2 99.7%) in 2021-2022. Myotomy length during a 'standard' POEM is 10.4cm, remaining over 10cm in non-spastic achalasia. The high heterogeneity across studies confirms that the POEM technique needs further standardization. We found no significant time trend towards adopting short POEM, despite recent evidence supporting its use.

Effectiveness of minimally invasive internal fixation with locking plates for mid-shaft clavicle fractures

To explore effectiveness of minimally invasive internal fixation with locking plates for mid-shaft clavicle fractures. Between October 2022 and August 2023, 28 patients with mid-shaft clavicle fractures were treated by minimally invasive internal fixation with locking plates. There were 10 males and 18 females with a mean age of 46.2 years (range, 18-74 years). The fractures were caused by traffic accident in 16 patients, sports-related injury in 7 patients, and other injuries in 5 patients. According to Robinson classification, the fractures were classified as type 2A1 in 1 case, type 2A2 in 6 cases, type 2B1 in 15 cases, and type 2B2 in 6 cases. The interval between fracture and operation ranged from 5 hours to 21 days (median, 1.0 days). The pain visual analogue scale (VAS) score was 8.1±1.6. The VAS score at 3 days after operation and the occurrence of complications after operation were recorded. During follow-up, X-ray films were re-examined to observe the healing of the fracture; the shoulder joint function was evaluated according to the Constant-Murley score at 6 months, and the length of the incision scar (total length of the distal and proximal incisions) was measured. All operations were successfully completed without any subclavian vascular or nerve damage. All incisions healed by first intention. The VAS score was 1.2±0.7 at 3 days after operation, and there was a significant difference in VAS score between pre- and post-operation ( t=8.704， P<0.001). At 1 week after operation, the patient's shoulder was basically painless, and they resumed normal life. All patients were followed up 12-20 months (mean, 13.3 months). X-ray films showed that the bone callus began to form at 2-4 months after operation (mean, 2.7 months). There was no delayed healing or non healing of the fracture, and no loosening or fracture of the internal fixators during follow-up. At 6 months after operation, the mean total incision length was 1.5 cm (range, 1.1-1.8 cm); no patient complained of numbness or paresthesia on subclavicular region or anterior chest wall. The Constant-Murley score of shoulder joint function was 93-100 (mean, 97.6). Minimally invasive internal fixation with locking plates is a good surgical method for treating mid-shaft clavicle fractures, with simple operation, minimal trauma, good postoperative results, and high satisfaction.

Comparative study of gastrointestinal tract size in three parent breeds for the production of dual-purpose organic chickens.

An alternative to culling male hatchlings of layers is breeding dual-purpose chickens. One breeding objective is the ability to digest low-quality feed. Certain measurements of the gastrointestinal tract may be useful indicators of this ability. The present study compared the gastrointestinal tract of adult hens of two layer-type breeds (White Rock (WR), New Hampshire (NH)) and the meat-type ÖTZ (Ökologische Tierzucht gGmbH) Bresse Gauloise (BR), used for the production of dual-purpose organic chickens. Flocks had the same housing and feeding conditions. At slaughter at 19 months, the body weight and gastrointestinal organs of 134 hens (51 WR, 55 NH and 28 BR) were measured. The muscle thickness of the proventriculus and ventriculus and the length and width of the duodenum, jejunoileum, caeca and colorectum were measured and variances between the groups were analysed using a one-factor covariance analysis. Significant differences between the breeds were found in total intestine length and the lengths and/or widths of single gastrointestinal segments. For example NH showed the highest mean total intestinal length and BR showed the lowest mean (NH: 186.73 cm, WR 185.86 cm, BR 157.91 cm; p = 0.001). To our knowledge, this is the first study comparing the gastrointestinal tract size of adult female layer- and meat-type chicken breeds kept under the same feeding and housing conditions. Given the possible relationship between intestinal length parameters and chicken performance, measurement of the gastrointestinal tract may be a simple, quick and inexpensive additional method to help select layer-, meat-type and dual-purpose chickens suitable for organic production when a selection process using genetic markers is not possible.

The benefits of a virtual emergency department observation unit for hospital observation patients

BackgroundThe benefit of virtual emergency department observation unit (EDOU) care relative to traditional observation care in an inpatient bed is unknown. ObjectiveTo determine if virtual observation care in an EDOU is associated with improved length of stay, cost, inpatient admission rate, and adverse events relative to traditional observation care in non-observation unit (NOU) inpatient bed. MethodsThis is a retrospective observational cohort study of observation patients managed over 24 months in two urban teaching hospitals. Following an ED visit, observation care occurred in a virtual-EDOU or NOU inpatient setting based on bed availability, physician discretion, and observation guidelines. Primary outcomes were length of stay, total cost, inpatient admission rate, and adverse events (death or ICU admission). Hospital cost and clinical databases were used. Analysis with a doubly-robust regression with entropy balancing and propensity scores was used to control for subgroup differences. Results30,191 observation patients were divided into 13,753 NOU patients and 16,438 EDOU patients with similar distributions for age and gender, and differences in health insurance and diagnosis. For both discharged and admitted patients, the mean cost was higher in the NOU setting at $7989 than the virtual-EDOU setting at $4876 with an adjusted difference of $1951 (95% CI: $1762–$2133). The mean total length of stay was higher in the NOU setting (60.5 h) than the virtual-EDOU setting (36.4 h) with an adjusted difference of 20.4 h (95% CI: 19.2 h – 21.3 h). NOU inpatient admission rates were higher (25.3% vs 18.4%). Cost and length of stays were lower in discharged observation patients, with differences favoring the virtual-EDOU group. Adverse events were higher in the NOU setting (2.1% vs 0.8%). 30-day ED recidivism did not differ significantly between NOU and virtual-EDOU study groups. The virtual-EDOU saved the two hospitals $16,036,913 and 6986 bed-days annually. ConclusionManagement of observation patients in a virtual-EDOU setting is superior to care in a traditional inpatient setting in terms of costs, length of stays, inpatient admission and adverse events rates.

Characterization of a Peruvian coastal fishery targeting the Pacific guitarfish Pseudobatos planiceps.

From December 2012 to June 2014, 796 Pacific guitarfish were caught in 183 fishing sets in northern Peru. Catch occurred in 86.3% of sets. Most individuals caught were mature with a bias toward males. The mean total length for females and males was 83.4 cm, and 91.1 cm, respectively. The capture per unit effort (CPUE) was 12.6 ± 3.4 guitarfish (km.12 h)-1. The length-weight relationships showed that this species presents a sexual dimorphism in growth. These results support the importance of Sechura Bay as a key area for this species. This study represents the first species-specific fishery data for the Pacific guitarfish.

Length-Weight, Length-Length Relationships and Condition Factor of Picarel, Spicara smaris (Linnaeus, 1758) Sampled from Aegean Sea and Black Sea

In this study, length-weight relationship (LWR), length-length relationship (LLR) and condition factor (K) of Spicara smaris (Linnaeus, 1758) collected from Aegean Sea and Black Sea during 2023-2024 fishing season were determined. A total of 116 samples (Aegean Sea N=56, Black Sea N=50) were obtained from commercial fishermen. The mean (±SD) total length and weight of samples varies between 15.47±0.98 cm, 34.82±6.45 g, and 12.35±1.40 cm, 20.01±8.93 g for Aegean and Black Sea, respectively. The slopes (b values) of the total length–weight regressions indicated (-) negative allometric growth to (+) positive allometric growth in localities. In addition, LLRs were calculated by using the linear regression model. LLRs were also highly significant (P

Characterising different artisanal fishing gears catches that operate in distinct habitats to assess ichthyofauna assemblages in Bons Sinais estuary, Mozambique

Monitoring the ichthyofauna is crucial to detect changes in aquatic communities for fisheries management and conservation. This study aimed to identify the most effective gear for ichthyofauna studies in the estuary. Thus, the performance of the beach seine (active gear) and chicocota (fixed gear), common fishing gears used by artisanal fishers in the Bons Sinais estuary (BSE), were used to characterise fish assemblage structure. Monthly surveys were conducted at two fixed sample points of the BSE to assess the composition of the fish assemblage. The analysis revealed statistical differences in abundance, biomass, and the presence/absence of different species between gears regardless sampling months. At ecological level, differences among gears were explained by different modus operandi, technological features and also different sampling habitats where gears operate; beach seine is catching bottom-bound and littoral fish while Chicocota is sampling the pelagic assemblage of the mid-channels. The frequency of occurrence of the 13 most abundant species differed between gears. Both gears showed little size-selectivity, with the mean total length and mean body height of these species statistically differing between gears. A total of 92 fish species were identified. No statistical differences were observed among gears for species richness, diversity and evenness. Both fishing gears captured several local socio-economically important species in the BSE. In particular, 13 of the most important species accounted for more than 54% and 60% of the total abundance and biomass in beach seine and chicocota, respectively. The complementary use of fixed and active fishing gears for studying fish community structure in estuaries is recommended. This multi-gear sampling approach enhances the capacity to detect changes in fish communities and provides valuable data for fisheries management and conservation efforts.

Vascular Foramina of Dry Human Talus: A Morphological Study.

Background The talus is the second largest tarsal bone and makes the osseous link between the leg and foot region.The branches of thedorsalis pedis, posterior tibial, and peroneal arteries enter vascular foramina (VF) on the various surfaces of the talus and provide intraosseous blood supply. Understanding the morphology and morphometry of VFmight be helpful in reducing the risk of vascular injury associated with surgical interventions to the talus. Aim and objectives The purpose of this study is to contribute reference data for the morphology of VFof talus in a sample from Türkiye. Materials and methods This study was performed on 62 dry talussamples from Türkiye.The number, location, size, and foraminal index of the VF were evaluated on each talus. The total and medial surface lengths, distances of the closest and furthest foramina on the inferior surface, and distances of the closest and furthest foramina on medial surface were measured. Results No VF was detected on articular surfaces and the head of the talus. The majority ofVF (1754; 81.17%)were detected on the neck, and 708 (40.36%) were located on the inferior surface of the neck. On the body, VF was mostly detected on the medial surface (233; 57.25%). The mean foraminal indices of the closest and furthest foramina on the inferior surface were 38.85%and 77.89%, respectively. The mean foraminal index of the closest foramina on the medial surface was 33.52%, and the furthest foramina on the medial surface was 63.91%. The total number of VF on 62 tali was determined as 2161. The majority (1521; 70.38%) of the size of VF was ≥0.6 mm. The mean total length was55.14±4.69 mm, and the medial surface lengthwas 49.18±4.18 mm. Conclusion Knowing the morphologic and morphometric properties of the VF gains importance during surgical interventions to the talus to reducevascular damage. According to our results, lateral approaches to the talus may be safer than other approaches. To our knowledge, there is no study about the morphology of VF of the talus in Türkiye samples.We believe thatthe results of this study will provide reference data for morphology and morphometry of VF of talus.

Livelihood status of the fishing community of Mahakanadarawa reservoir in Anuradhapura, Sri Lanka

Mahakanadarawa reservoir located in Anuradhapura is one of the major, perennial reservoirs in Sri Lanka, extending over 1,457 ha. It provides livelihood opportunities through fisheries, irrigation for agriculture, and fostering economic growth in the surrounding region. Yet the fisheries-based livelihoods of the Mahakanadarawa reservoir have not been fully assessed. Hence, this study investigated the fishery and fisher profile of the reservoir. Primary data were collected from eight landing sites. A pre-tested questionnaire was used to interview 72 fishermen using a mixed method. Main variables including social, human, physical, natural, and financial capitals, fishery profile, fish and fisheries-based post-harvesting techniques, market chain analysis, and fisheries management practices, catch per unit effort for the gillnet fishery were calculated. Secondary data including stocking fish fingerlings and species-wise harvesting data for the past 10 years were collected from the district aquaculture extension office (Anuradhapura) of the NAQDA. A secondary study on the length-weight relationship of Oreochromis niloticus along with its condition factor value was performed. It was revealed that O. niloticus had negative allometric fish growth (b = 2.6667) with a condition factor value of 1.9092. The female fish had a higher mean total length compared to the male fish. In the fishing community, 95.83% of males and 4.17% of females were engaged in fishery activities. Mainly gill nets and non-mechanized fiberglass canoes were used for fishing. The average CPUE was 0.000339 kgm-2day-1. A strong positive (r =0.841) correlation was reported for fish stocking and fish production. Fish smoking and sun drying were the common fish processing techniques. The fish supply chain targeted the regional market. A cooperative level co-management system was identified among the reservoir fishing community. The current study discloses the livelihood capitals of the fishing community along with the existing supply chain which can be utilized for the sustainable management strategy of the Mahakanadarawa reservoir in the long run.

Enhanced recovery after surgery (ERAS) novel protocol for management of esophageal replacement in children: A single surgeon's experience of 116 cases

BackgroundPerioperative management of esophageal replacement is challenging due to significant disturbance in internal milieu of the body. To mitigate mediastinal dissection induced systemic inflammatory response, there is an unmet need to design and test a goal directed, resource conscious protocol for enhanced recovery, which will serve as a template to reduce morbid surgical complications and length of hospital stay. MethodsA retrospective cohort study was designed by convenience sampling method to group patients to compare outcomes of pediatric esophageal replacement using conventional protocol vs enhanced recovery after surgery novel protocol. Primary outcome measure was post-operative total length of stay in hospital. Secondary outcome measures were frequency of cardio-pulmonary complications, anastomotic leaks, infections, mortality, and initiation of early enteral jejunostomy feeding. ResultsA total of 116 children with corrosive esophageal injury [n = 21(19%)] and esophageal atresia [n = 95(81 %)] were analyzed in this study. Novel protocol group(n = 62) when compared to conventional protocol group (n = 54) had lower mean total length of stay days (13.05 ± 7.92 days vs.21.96 ± 6.5 days p < 0.0001), shorter mean ICU days (5.74 ± 4.16 days vs 7.13 ± 3.16 days; p ≤ 0.048) and Novel protocol group had lower cardiac [3/62 (5 %) vs 12/54(22 %) p = 0.012]; and pulmonary [4/62 (6.5 %) vs 13/54(24 %) p = 0.007] complications. Novel protocol group had lower mean days to initiation of enteral feeding (3.13 ± 0.71 vs 5.45 ± 0.75 days; p < 0.0001) and lower rates of post-operative infections [5/62(8 %) vs 18/54 (33 %); p = 0.001]. ConclusionsEnhanced recovery after surgery novel protocol has the potential to change clinical practice due to mitigation of major complications.

The prevalence of sedentary behavior among university students in Saudi Arabia

BackgroundA considerable body of research has demonstrated that reducing sitting time benefits health. Therefore, the current study aimed to explore the prevalence of sedentary behavior (SB) and its patterns.MethodsA total of 6975 university students (49.1% female) were chosen randomly to participate in a face-to-face interview. The original English version of the sedentary behavior questionnaire (SBQ) was previously translated into Arabic. Then, the validated Arabic version of the SBQ was used to assess SB. The Arabic SBQ included 9 types of SB (watching television, playing computer/video games, sitting while listening to music, sitting and talking on the phone, doing paperwork or office work, sitting and reading, playing a musical instrument, doing arts and crafts, and sitting and driving/riding in a car, bus or train) on weekdays and weekends.ResultsSBQ indicated that the total time of SB was considerably high (478.75 ± 256.60 and 535.86 ± 316.53 (min/day) during weekdays and weekends, respectively). On average, participants spent the most time during the day doing office/paperwork (item number 4) during weekdays (112.47 ± 111.11 min/day) and weekends (122.05 ± 113.49 min/day), followed by sitting time in transportation (item number 9) during weekdays (78.95 ± 83.25 min/day) and weekends (92.84 ± 100.19 min/day). The average total sitting time of the SBQ was 495.09 ± 247.38 (min/day) and 58.4% of the participants reported a high amount of sitting time (≥ 7 hours/day). Independent t-test showed significant differences (P ≤ 0.05) between males and females in all types of SB except with doing office/paperwork (item number 4). The results also showed that male students have a longer daily sitting time (521.73 ± 236.53 min/day) than females (467.38 ± 255.28 min/day). Finally, 64.1% of the males reported a high amount of sitting time (≥ 7 hours/day) compared to females (52.3%).ConclusionIn conclusion, the total mean length of SB in minutes per day for male and female university students was considerably high. About 58% of the population appeared to spend ≥7 h/day sedentary. Male university students are likelier to sit longer than female students. Our findings also indicated that SB and physical activity interventions are needed to raise awareness of the importance of adopting an active lifestyle and reducing sitting time.

Usage of rotational atherectomy and drug-coated balloon angioplasty for isolated popliteal artery lesions: two-year results of a retrospective study

Objectives In this study, perioperative properties and early and mid-term clinical outcomes of endovascular revascularization with a combined usage of rotational atherectomy (RA) and drug-coated balloon angioplasty (DCB) angioplasty for isolated popliteal artery lesion were reported. Methods A total of 28 patients with isolated popliteal artery stenosis who underwent combined RA and DCB angioplasty between December 2018 and September 2022 were analyzed retrospectively. Temren atherectomy system (Invamed, Ankara, Turkey) and Extender paclitaxel-coated drug-coated balloon catheter (Invamed, Ankara, Turkey) were used in all cases. The main outcome was primary patency; secondary outcomes were technical success, freedom from amputation, and mortality. Results The mean age of patients was 64.2 ± 9.1 years and the majority of the patients were male (n = 20; 71.4%). Types of the lesions were total occlusion in 24 limbs and critical stenosis in 4 limbs. The mean total occlusion length was 65.2 ± 14.2 mm. Flow-limiting dissection was seen in lesions of 2 patients (7.1%) and treated with prolonged balloon dilatation without bail-out stenting requirement. Technical success defined as an adequate vascular lumen (less than 30% stenosis) was achieved in 26 (92.8%) with a mean follow-up of 17.2 ± 8.2 months. The mean primary patency rates at 12 months and 24 months were 92.3% ± 3.2 and 81.2% ± 3.2, respectively. Complications included 1 distal embolization following RA, 2 flow-limiting dissections, and 3 puncture site hematomas. Conclusions Endovascular procedures using combined RA and DCB angioplasty seem to be effective alternative treatment modalities for the treatment of popliteal artery lesions with high rates of primary patency and freedom from TLR.

Effects of Codeine on Esophageal Peristalsis in Patients With Ineffective Esophageal Motility: Studies Using High-resolution Manometry.

This study aims to evaluate the effects of acute codeine administration on primary and secondary esophageal peristalsis in patients with ineffective esophageal motility (IEM). Eighteen IEM patients (8 women; mean age 37.8 years, range 23-64 years) were enrolled in the study. The patients underwent high-resolution manometry exams, consisting of 10 single wet swallows, multiple rapid swallows, and ten 20 mL rapid air injections to trigger secondary peristalsis. All participants completed 2 separate sessions, including acute administration of codeine (60 mg) and placebo, in a randomized order. Codeine significantly increased the distal contractile integral (566 ± 81 mmHg∙s∙cm vs 247 ± 36 mmHg∙s∙cm, P = 0.001) and shortened distal latency (5.7 ± 0.2 seconds vs 6.5 ± 0.1 seconds, P < 0.001) for primary peristalsis compared with these parameters after placebo treatment. The mean total break length decreased significantly after codeine treatment compared with the length after placebo (P = 0.003). Codeine significantly increased esophagogastric junction-contractile integral (P = 0.028) but did not change the 4-second integrated relaxation pressure (P = 0.794). Codeine significantly decreased the frequency of weak (P = 0.039) and failed contractions (P = 0.009), resulting in increased frequency of normal primary peristalsis (P < 0.136). No significant differences in the ratio of impaired multiple rapid swallows inhibition and parameters of secondary peristalsis were detected. In IEM patients, acute administration of codeine increases contraction vigor and reduces distal latency of primary esophageal peristalsis, but has no effect on secondary peristalsis. Future studies are required to further elucidate clinical relevance of these findings, especially in the setting of gastroesophageal reflux disease with IEM.

Growth Condition, Length-Weight Relationship and Morphological Diversity of Sarotherodon melanotheron and Tilapia guineensis inhabiting the Coastal Waters of Ondo State, Nigeria

Sarotherodon melanotheron and Tilapia guineensis were studied in Mahin Lagoon and Idiogba in the coastal waters of Ondo State to determine their sizes, length-weight relationships, and condition factors. The mean total length and weight for S. melanotheron were 13.35±1.66 cm and 48.41±20.89 g in Mahin, and 13.44±1.72 cm and 49.96±20.80 g in Idiogba, respectively. Meanwhile, the values recorded for T. guineensis were 16.06±4.83 cm and 104.81±107.94 g in Mahin, and 15.00±3.74 cm and 78.98±81.51 g in Idiogba. This morphological similarity revealed an overlap of data between the populations of the two species in Mahin Lagoon and Idiogba. The regression coefficient (b) of length and weight revealed that S. melanotheron exhibited hypoallometry (b=2.55; a=-2.76; R2=0.78) in Mahin and (b=2.31; a=-2.13; R2=0.78) in Idiogba, while T. guineensis exhibited hyperallometry (b=3.04; a=-4.06; R2=0.96) in Mahin and (b=3.05; a=-4.11; R2=0.92) in Idiogba. The condition factor was greater than 2 for both species, although it was higher in T. guineensis (K=2.53 in Mahin and K=2.34 in Idiogba) than in S. melanotheron (K=2.04 in Mahin and K=2.06 in Idiogba). Therefore, this study revealed that both species were very fat and healthy despite anthropogenic activities in the study area.