Outcomes of same-day discharge in bariatric surgery.

BACKGROUND: Restrictions during the COVID-19 pandemic influenced a shift to same-day discharge in bariatric surgery. Current studies show conflicting findings regarding morbidity and mortality. We aim to compare outcomes for same-day discharge versus admission after bariatric surgery. METHODS: Subjects included patients who underwent primary laparoscopic or robotic-assisted sleeve gastrectomy or Roux-En-Y gastric bypass at an academic center. The inpatient group included patients discharged postoperative day one, and the outpatient group included patients discharged on the day of surgery. Primary outcomes included the number of emergency room visits, reoperations, IV fluid treatments, readmissions, and mortality within 30 days. Secondary outcomes were morbidity, including skin and soft tissue infection, pulmonary embolism, and acute kidney injury. RESULTS: 1225 patients met the inclusion criteria. In the gastric sleeve group, 852 subjects were outpatients and 227 inpatients. In the gastric bypass group, 70 subjects were outpatients, and 40 were inpatients. The mean age was 44.63 (17.38-85.31) years, and the mean preoperative BMI was 46.07 ± 8.14 kg/m2. The subjects in the outpatient group had lower BMI with fewer comorbidities. The groups differed significantly in age, BMI, and presence of several chronic comorbidities. The inpatient and outpatient groups for each surgery type did not differ significantly regarding reoperations, IV fluid treatments, or 30-day mortality. The inpatient sleeve group demonstrated a significantly higher readmission percentage than the outpatient group (4.6% vs 2.1%; p = 0.02882). The inpatient bypass group showed significantly greater ER visits (21.7% vs 10%; p = 0.0108). The incidence of adverse events regarding the secondary outcomes was not statistically different. CONCLUSION: Same-day discharge after bariatric surgery is a safe and reasonable option for patients with few comorbidities.

Thousands of induced germline mutations affecting immune cells identified by automated meiotic mapping coupled with machine learning.

Forward genetic studies use meiotic mapping to adduce evidence that a particular mutation, normally induced by a germline mutagen, is causative of a particular phenotype. Particularly in small pedigrees, cosegregation of multiple mutations, occasional unawareness of mutations, and paucity of homozygotes may lead to erroneous declarations of cause and effect. We sought to improve the identification of mutations causing immune phenotypes in mice by creating Candidate Explorer (CE), a machine-learning software program that integrates 67 features of genetic mapping data into a single numeric score, mathematically convertible to the probability of verification of any putative mutation-phenotype association. At this time, CE has evaluated putative mutation-phenotype associations arising from screening damaging mutations in ∼55% of mouse genes for effects on flow cytometry measurements of immune cells in the blood. CE has therefore identified more than half of genes within which mutations can be causative of flow cytometric phenovariation in Mus musculus The majority of these genes were not previously known to support immune function or homeostasis. Mouse geneticists will find CE data informative in identifying causative mutations within quantitative trait loci, while clinical geneticists may use CE to help connect causative variants with rare heritable diseases of immunity, even in the absence of linkage information. CE displays integrated mutation, phenotype, and linkage data, and is freely available for query online.

Sleep Abnormalities in SLC13A5 Citrate Transporter Disorder.

BACKGROUND: SLC13A5 Citrate Transporter Disorder is a rare pediatric neurodevelopmental disorder. Patients have epilepsy, developmental disability, and impaired mobility. While sleep disorders are common in children with neurodevelopmental disorders, sleep abnormalities have not been reported in SLC13A5 patients. METHODS: Here, we assessed sleep disturbances in patients through caregiver reported surveys and in a transgenic mouse model of SLC13A5 deficiency. A total of 26 patients were evaluated with the Sleep Disturbance Scale for Children three times over a one-year span. Sleep and wake activities were assessed in the SLC13A5 knock-out (KO) mice using wireless telemetry devices. RESULTS: A high burden of clinically significant sleep disturbances were reported in the patients, with heterogeneous symptoms that remained stable across time. While sleep disturbances were common, less than 30% of patients were prescribed medications for sleep. Comparatively, in SLC13A5 KO mice using EEG recordings, significant alterations were found during light cycles, when rodents typically sleep. During the sleep period, SLC13A5 mice had increased activity, decreased paradoxical sleep, and changes in absolute power spectral density, indicating altered sleep architecture in the mouse model. CONCLUSIONS: Our results demonstrate a significant component of sleep disturbances in SLC13A5 patients and mice, highlighting a potential gap in patient care. Further investigation of sleep dysfunction and the underlying etiologies of sleep disturbances in SLC13A5 citrate transporter disorder is warranted.

Pre-Event Self-Efficacy and Sports Performance: A Systematic Review with Meta-Analysis.

The relationship between self-efficacy and performance exclusively within the sports environment is yet to be quantified. Hence, we meta-analysed this relationship by following the PRISMA guidelines. Two previous meta-analyses, five relevant databases, and Google Scholar were searched. Forty-four articles published between 1983 and 2021 met the inclusion criteria, with 55 independent samples. Comprehensive meta-analysis software version 4 was used for all meta-analytic calculations using a random-effects model to calculate the mean effect size, and a mixed-effects model was used for moderation analyses. The mean pre-event self-efficacy and performance effect size was r = 0.31 (95% CI 0.22, 0.40). For moderation analyses, notable mean differences (p values ≥ 0.08) resulted for concordance [concordant (r = 0.37), nonconcordant (r = 0.22)], sports skill [closed (r = 0.37), open (r = 0.23)], and athlete level [elite (r = 0.40), sub-elite (r = 0.28)]. The true effect prediction interval ranged from negative (i.e., self-efficacy impairing performance) to positive (self-efficacy improving performance) for all moderator variables except self-referenced vs. other-referenced performance. In conclusion, the relationship between pre-event self-efficacy and performance is positive and moderate in magnitude, although with prediction intervals ranging from debilitating to facilitating performance. Researchers and practitioners should note that high athlete-rated self-efficacy might not always improve impending competitive sports performance.

A Systematic Review of the Sport Psychology Mixed Martial Arts Literature: Replication and Extension.

MMA is a global sport with a growing body of psychological literature. Our main objective was to replicate and extend a past review concerning the sport psychology literature with MMA participants. We conducted our electronic search in EBSCO with the following databases: SPORTDiscus, PsycINFO, ERIC, and Psychology and Behavioral Sciences Collection. Our eligibility criteria were research articles (a) found in academic journals, (b) with MMA participants, and (c) at least one topic found in sport psychology literature. After conducting a PRISMA-guided search, 16 studies met our inclusion criteria. The studies spanned from 2011 to 2021, with 795 MMA participants from the USA (n = 7), Brazil (n = 4), and one study each from Czechia, Poland, Spain, Sweden, and the United Kingdom. From studies reporting mean ages, MMA participants were in their mid-20s (M = 26.55 ± 2.38 years of age). The results section includes risk of bias ratings across five areas (i.e., subject selection, sample's MMA background, participant anonymity, data collection procedures, and questionnaire or qualitative theme reporting). More risk of bias concerns resulted with the quantitative than qualitative articles. To best represent the studies, we presented separate results tables with many specifics for both the quantitative (i.e., topic, main analysis, time frame, summary of results, and meaningfulness) and qualitative studies (topic, main analysis, time frame, and main themes). The included studies covered a variety of historic and meta-analyzed topics such as confidence, mood, motivations, and social facilitation. Based on our review, we discussed the literature strengths and limitations, and suggested future research directions. Last, we provided practical points for both MMA participants and their trainers.

The Athletic Identity Measurement Scale: A Systematic Review with Meta-Analysis from 1993 to 2021.

Sport psychology embraced the study of athletic identity in the 1990s. The Athletic Identity Measurement Scale (AIMS) is at the forefront of athletic identity measurement. This quantitative review examined two hypotheses: individual who are most engaged in sports identify most as athletes and thus score higher on the AIMS, and athletic identity relates to positive (e.g., intrinsic motivation) and negative (negative emotions) factors. In addition to our two hypotheses, we explored whether the AIMS subscales influenced our two hypotheses. After completing a systematic search of SPORTDiscus, APA PsycINFO, ERIC, and Psychology and Behavioral Sciences Collection APA within the EBSCOhost platform along with some hand searching, 101 articles published between 1993 and our end date of August 2021 met the inclusion criteria. The included studies investigated 20,498 athletes competing in a variety of sports from the following continents: Australia, Asia, Europe, and North America. We based all analyses on random- and mixed-effects statistics. Higher-achieving athletes, as expected, self-reported a higher degree of athletic identity. The differences between athlete groups were significant (p < 0.001) and meaningful (g values ranged from 1.55 to 1.93). The AIMS total score correlations with positive and negative factors (correlates) were small in magnitude (r = 0.22 and 0.17). However, the relationships differed across correlate subcategories (e.g., intrinsic motivation/commitment, r = 0.51, and body issues, r = 0.14). Minimal AIMS subscale reporting occurred across the 101 studies; thus, we could not assess their importance with certainty. In conclusion, a higher degree of athletic identity related to valued sport correlates such as intrinsic motivation/commitment and the mastery goal orientation. These correlations were small in relation to negative or less desirable factors in sport such as body disorder issues and negative emotions. We recommend future research of greater complexity and the reporting of athletes' competitive backgrounds to understand athletic identity. In addition, researchers should report AIMS subscale data.

Revisiting the Self-Confidence and Sport Performance Relationship: A Systematic Review with Meta-Analysis.

Self-confidence is a common research topic, and most applied textbooks include interventions designed to enhance athlete confidence. Our purpose was to quantify the self-confidence and sport performance literature using meta-analytic techniques. We also examined potential risk of bias indicators, and the moderation effects of study quality, sport characteristics, timing of confidence measurement, and individual differences among participants. Following a review of two past meta-analyses, a systematic search of APA PsycArticles, ERIC, Psychology and Behavioral Sciences Collection, PsychINFO, and SPORTDiscus within the EBSCOhost platform, and some hand searching, 41 articles published between 1986 and 2020 met the inclusion criteria. Collectively, the included studies investigated 3711 athletes from 15 countries across 24 sports. The overall random effects estimate of the relationship (expressed as r) between self-confidence and performance was 0.25 (95% CI 0.19, 0.30), with little evidence of publication bias. The summed total risk of the individual study bias score did not moderate the confidence-performance relationship, whereas significant moderator effects emerged for individual sports (0.29) compared with team sports (0.14), objective (0.29) compared to subjective (0.14) performance measures, and 100% male (0.35) compared to 100% female (0.07) samples. In conclusion, the confidence-performance relationship is small in magnitude, nearly free of bias, and moderated by sport type, performance objectivity, and athlete sex.

Validation of a Lithuanian-Language Version of the Brunel Mood Scale: The BRUMS-LTU.

Mood can be considered as a diffuse and global emotional state, with both valence and arousal characteristics, that is not directed towards a specific object. Investigation of moods in specific language and cultural contexts relies on the availability of appropriately validated measures. The current study involved the translation and validation of the Brunel Mood Scale (BRUMS) from English into Lithuanian. The 24-item, 6-factor scale, referred to as the BRUMS-LTU, was administered to 746 participants who were fluent in Lithuanian (nmen = 199 (26.7%), nwomen = 547 (73.3%); age range = 17-78 years, M = 41.8 years, SD = 11.4 years). Confirmatory factor analysis showed an adequate fit of the hypothesized measurement model to the data (CFI = 0.954, TLI = 0 .944, RMSEA = 0 .060 [CI 0.056, 0.064], SRMR = 0.070) and multi-sample analysis supported configural, metric, scalar, and residual invariance across genders. Concurrent measures (i.e., Perceived Stress Scale, Big Five Personality Test) correlated with subscale scores in line with theoretical predictions, supporting both convergent and divergent validity. Internal consistency coefficients of the six subscales were satisfactory. Mood scores varied significantly by gender, with men generally reporting more positive moods than women. Findings support the adequacy of the psychometric properties of the BRUMS-LTU. Thus, the scale can be recommended for use in further psychological studies of mood in Lithuania and may also be useful for applied practitioners.

Sport psychology and performance meta-analyses: A systematic review of the literature.

Sport psychology as an academic pursuit is nearly two centuries old. An enduring goal since inception has been to understand how psychological techniques can improve athletic performance. Although much evidence exists in the form of meta-analytic reviews related to sport psychology and performance, a systematic review of these meta-analyses is absent from the literature. We aimed to synthesize the extant literature to gain insights into the overall impact of sport psychology on athletic performance. Guided by the PRISMA statement for systematic reviews, we reviewed relevant articles identified via the EBSCOhost interface. Thirty meta-analyses published between 1983 and 2021 met the inclusion criteria, covering 16 distinct sport psychology constructs. Overall, sport psychology interventions/variables hypothesized to enhance performance (e.g., cohesion, confidence, mindfulness) were shown to have a moderate beneficial effect (d = 0.51), whereas variables hypothesized to be detrimental to performance (e.g., cognitive anxiety, depression, ego climate) had a small negative effect (d = -0.21). The quality rating of meta-analyses did not significantly moderate the magnitude of observed effects, nor did the research design (i.e., intervention vs. correlation) of the primary studies included in the meta-analyses. Our review strengthens the evidence base for sport psychology techniques and may be of great practical value to practitioners. We provide recommendations for future research in the area.

Surface Area Graphic Evaluation (SAGE) Diagram Documentation in Burn Patients: Room for Quality Improvement.

Background The first step in the management of burn patients is an accurate estimation of the total body surface area (TBSA) involvement. Depending on which, burns are categorized as major (>20%) and minor (<20%). This then dictates fluid resuscitation and level of care. At the University of New Mexico Burn Center, we use Surface Area Graphic Evaluation (SAGE) diagramming to objectively estimate the body surface area involvement. We hypothesized patients undergoing SAGE documentation will have better outcomes.  Methods This is a retrospective study of 320 consecutive patients from 2014-2018 at the University of New Mexico Burn Center. Only patients treated surgically were included. We recorded patient demographics, comorbidities, and burn details. The primary measure of interest was SAGE documentation and the secondary measure of interest was outcomes associated with it. Results We found that a SAGE diagram was only documented for a minority of patients (40%). After comparing patients in the SAGE group vs. No SAGE group, we found that the patients were the same in both groups with regards to demographics, comorbidities, and burn characteristics. The use of a SAGE diagram did not appear to be a significant predictor of complications, including surgical site infections, graft loss, donor site complications, postoperative pneumonia, urinary tract infections, deep vein thrombosis, or myocardial infarction (p=0.254). Conclusion Only a minority of patients get a SAGE diagram documented. However, our study did not find any improved outcomes with the use of a SAGE diagram. There is a need for prospective studies to validate the utility of SAGE diagramming in predicting adverse outcomes in major burns.