The Impact of Food Insecurity Rate on Bariatric Surgery Outcomes.

INTRODUCTION: Various factors impact outcomes following bariatric surgery. Lack of access to healthy food options (food insecurity [FI]) is another potential factor affecting outcomes. No prior studies have directly explored the relationship between residing in a high FI zip code and patient outcomes relating to weight loss after bariatric surgery. We hypothesized that living in a high FI zip code would be associated with decreased weight loss postsurgery. METHODS: We conducted a retrospective study with 210 bariatric surgery patients at a tertiary referral center from January to December 2020. Patient weight and body mass index (BMI) were recorded at three time points: surgery date, 1 mo, and 12 mo postoperative. Residential addresses were collected, and FI rates for the corresponding Zip Code Tabulation Areas were obtained from the 2022 Feeding America Map the Meal Gap study (2020 data). RESULTS: The FI rate showed a negative correlation of -18.3% (95% confidence interval: -35% to -0.5%; P = 0.039) with the percentage of excess weight loss (%EWL) at 1 y. In multivariate analysis, preoperative BMI (P = 0.001), presence of diabetes mellitus (P = 0.008), and bariatric procedure type (P = 0.000) were significant predictors of %EWL at 1 y. After adjusting for confounding factors, including sex, preoperative BMI, insurance status, primary bariatric procedure, and emergency department visits, the increased FI rate (P = 0.047) remained significantly associated with a decreased %EWL at 1 y. CONCLUSIONS: Residing in a high FI, Zip Code Tabulation Areas correlated with a decreased %EWL at 1 y after bariatric surgery. These findings highlight the importance of assessing FI status in pre-bariatric surgery patients and providing additional support to individuals facing FI.

Cascading hazards of a major Bengal basin earthquake and abrupt avulsion of the Ganges River.

Earthquakes present severe hazards for people and economies and can be primary drivers of landscape change yet their impact to river-channel networks remains poorly known. Here we show evidence for an abrupt earthquake-triggered avulsion of the Ganges River at ~2.5 ka leading to relocation of the mainstem channel belt in the Bengal delta. This is recorded in freshly discovered sedimentary archives of an immense relict channel and a paleo-earthquake of sufficient magnitude to cause major liquefaction and generate large, decimeter-scale sand dikes >180 km from the nearest seismogenic source region. Precise luminescence ages of channel sand, channel fill, and breached and partially liquefied floodplain deposits support coeval timing of the avulsion and earthquake. Evidence for reorganization of the river-channel network in the world's largest delta broadens the risk posed by seismic events in the region and their recognition as geomorphic agents in this and other tectonically active lowlands. The recurrence of comparable earthquake-triggered ground liquefaction and a channel avulsion would be catastrophic for any of the heavily populated, large river basins and deltas along the Himalayan arc (e.g., Indus, Ganges, Brahmaputra, Ayeyarwady). The compounding effects of climate change and human impacts heighten and extend the vulnerability of many lowlands worldwide to such cascading hazards.

Characteristics and kinetics of thermophilic actinomycetes' amylase production on agro-wastes and its application for ethanol fermentation.

Thermophilic actinomycetes are commonly found in extreme environments and can thrive and adapt to extreme conditions. These organisms exhibit substantial variation and garnered significant interest due to their remarkable enzymatic activities. This study evaluated the potential of Streptomyces griseorubens NBR14 and Nocardiopsis synnemataformans NBRM9 strains to produce thermo-stable amylase via submerged fermentation using wheat and bean straw. The Box-Behnken design was utilized to determine the optimum parameters for amylase biosynthesis. Subsequently, amylase underwent partial purification and characterization. Furthermore, the obtained hydrolysate was applied for ethanol fermentation using Saccharomyces cerevisiae. The optimal parameters for obtaining the highest amylase activity by NBR14 (7.72 U/mL) and NBRM9 (26.54 U/mL) strains were found to be 40 and 30 °C, pH values of 7, incubation time of 7 days, and substrate concentration (3 and 2 g/100 mL), respectively. The NBR14 and NBRM9 amylase were partially purified, resulting in specific activities of 251.15 and 144.84 U/mg, as well as purification factors of 3.91 and 2.69-fold, respectively. After partial purification, the amylase extracted from NBR14 and NBRM9 showed the highest activity level at pH values of 9 and 7 and temperatures of 50 and 60 °C, respectively. The findings also indicated that the maximum velocity (Vmax) for NBR14 and NBRM9 amylase were 57.80 and 59.88 U/mL, respectively, with Km constants of 1.39 and 1.479 mM. After 48 h, bioethanol was produced at concentrations of 5.95 mg/mL and 9.29 mg/mL from hydrolyzed wheat and bean straw, respectively, through fermentation with S. cerevisiae. Thermophilic actinomycetes and their α-amylase yield demonstrated promising potential for sustainable bio-ethanol production from agro-byproducts.

Disposable Gastrointestinal Scopes: A Systematic Review.

OBJECTIVE: Endoscopes are an essential tool in the diagnosis, screening, and treatment of gastrointestinal diseases. In 2019, the Food and Drug Administration issued a news release, recommending that duodenoscope manufacturers and health care facilities phase out fully reusable duodenoscopes with fixed endcaps in lieu of duodenoscopes that are either fully disposable or those that contain disposable endcaps. With this study, we systematically reviewed the published literature on single-use disposable gastrointestinal scopes to describe the current state of the literature and provide summary recommendations on the role of disposable gastrointestinal endoscopes. MATERIALS AND METHODS: For our inclusion criteria, we searched for studies that were published in the year 2015 and afterward. We performed a literature search in PubMed using the keywords, "disposable," "reusable," "choledochoscope," "colonoscope," "duodenoscope," "esophagoscope," "gastroscope," and "sigmoidoscope." After our review, we identified our final article set, including 13 articles relating to disposable scopes, published from 2015 to 2023. RESULTS: In this review, we show 13 articles discussing the infection rate, functionality, safety, and affordability of disposable gastrointestinal scopes in comparison to reusable gastrointestinal scopes. Of the 3 articles that discussed infection rates (by Forbes and colleagues, Ridtitid and colleagues, and Ofosu and colleagues), each demonstrated a decreased risk of infection in disposable gastrointestinal scopes. Functionality was another common theme among these articles. Six articles (by Muthusamy and colleagues, Bang and colleagues, Lisotti and colleagues, Ross and colleagues, Kang and colleagues, and Forbes and colleagues) demonstrated comparable functionality of disposable scopes to reusable scopes. The most reported functionality issue in disposable scopes was decreased camera resolution. Disposable scopes also showed comparable safety profiles compared with reusable scopes. Six articles (by Kalipershad and colleagues, Muthusamy and colleagues, Bang and colleagues, Lisotti and colleagues, Luo and colleagues, and Huynh and colleagues) showed comparable rates of AEs, whereas 1 article (by Ofosu and colleagues) demonstrated increased rates of AEs with disposable scopes. Lastly, a cost analysis was looked at in 3 of the articles. Two articles (by Larsen et al and Ross and colleagues) remarked that further research is needed to understand the cost of disposable scopes, whereas 1 article (by Kang and colleagues) showed a favorable cost analysis. CONCLUSIONS: After a review of the literature published since the 2015 Food and Drug Administration safety communication, disposable scopes have been shown to be effective in decreasing infection risks while maintaining similar safety profiles to conventional reusable scopes. However, more research is required to compare disposable and reusable scopes in terms of functionality and cost-effectiveness.

Endoscopic closure techniques of bariatric surgery complications: a meta-analysis.

BACKGROUND: Leaks following bariatric surgery, while rare, are potentially fatal due to risk of peritonitis and sepsis. Anastomotic leaks and gastro-gastric fistulae following Roux-En-Y gastric bypass (RYGB) as well as staple line leaks after sleeve gastrectomy have historically been treated multimodally with surgical drainage, aggressive antibiotic therapy, and more recently, endoscopically. Endoscopic clipping using over-the-scope clips and endoscopic suturing are two of the most common approaches used to achieve full thickness closure. METHODS: A systematic literature search was performed in PubMed to identify articles on the use of endoscopic clipping or suturing for the treatment of leaks and fistulae following bariatric surgery. Studies focusing on stents, and those that incorporated multiple closure techniques simultaneously, were excluded. Literature review and meta-analysis were performed with the PRISMA guidelines. RESULTS: Five studies with 61 patients that underwent over-the-scope clip (OTSC) closure were included. The pooled proportion of successful closure across the studies was 81.1% (95% CI 67.3 to 91.7). The successful closure rates were homogeneous (I2 = 39%, p = 0.15). Three studies with 92 patients that underwent endoscopic suturing were included. The weighted pooled proportion of successful closure across the studies was shown to be 22.4% (95% CI 14.6 to 31.3). The successful closure rates were homogeneous (I2 = 0%, p = 0.44). Three of the studies, totaling 34 patients, examining OTSC deployment reported data for reintervention rate. The weighted pooled proportion of reintervention across the studies was 35.0% (95% CI 11.7 to 64.7). We noticed statistically significant heterogeneity (I2 = 68%, p = 0.04). One study, with 20 patients examining endoscopic suturing, reported rate of repeat intervention 60%. CONCLUSION: Observational reports show that patients managed with OTSC were more likely to experience healing of their defect than those managed with endoscopic suturing. Larger controlled studies comparing different closure devices for bariatric leaks should be carried out to better understand the ideal endoscopic approach to these complications.

Ageing and Mental Health in the Context of Social Isolation in Covid-19 Pandemic.

The Covid-19 pandemic has introduced the world to a new chapter in the last three to four years. The focus of this review is on a significant but often overlooked group and topic that has received limited research attention. Recent studies show that the psychological impact of the COVID-19 pandemic is still intense, even around three years later. This article will summarize and discuss the results of 52 studies on anxiety, depression, post-traumatic stress symptoms (PTSS), fear of loneliness, suicidal ideation, and resilience in the elderly population before and after the SARS-CoV-2 pandemic. In addition to detrimental effects, attention is also given to the improved coping abilities and lack of significant psychological distress among the geriatric population when compared to younger age groups. This review will encompass research conducted on both the population of Bangladesh and the global population as a whole.

Nocardiopsis synnemataformans NBRM9, an extremophilic actinomycete producing extremozyme cellulase, using lignocellulosic agro-wastes and its biotechnological applications.

Actinomycetes are an attractive source of lignocellulose-degrading enzymes. The search for actinomycetes producing extremozyme cellulase using cheap lignocellulosic waste remains a priority goal of enzyme research. In this context, the extremophilic actinomycete NBRM9 showed promising cellulolytic activity in solid and liquid assays. This actinomycete was identified as Nocardiopsis synnemataformans based on its phenotypic characteristics alongside phylogenetic analyses of 16S rRNA gene sequencing (OQ380604.1). Using bean straw as the best agro-waste, the production of cellulase from this strain was statistically optimized using a response surface methodology, with the maximum activity (13.20 U/mL) achieved at an incubation temperature of 40 °C, a pH of 9, an incubation time of 7 days, and a 2% substrate concentration. The partially purified cellulase (PPC) showed promising activity and stability over a wide range of temperatures (20-90 °C), pH values (3-11), and NaCl concentrations (1-19%), with optimal activity at 50 °C, pH 9.0, and 10% salinity. Under these conditions, the enzyme retained >95% of its activity, thus indicating its extremozyme nature. The kinetics of cellulase showed that it has a Vmax of 20.19 ± 1.88 U/mL and a Km of 0.25 ± 0.07 mM. The immobilized PPC had a relative activity of 69.58 ± 0.13%. In the in vitro microtiter assay, the PPC was found to have a concentration-dependent anti-biofilm activity (up to 85.15 ± 1.60%). Additionally, the fermentative conversion of the hydrolyzed bean straw by Saccharomyces cerevisiae (KM504287.1) amounted to 65.80 ± 0.52% of the theoretical ethanol yield. Overall, for the first time, the present work reports the production of extremozymatic (thermo, alkali-, and halo-stable) cellulase from N. synnemataformans NBRM9. Therefore, this strain is recommended for use as a biotool in many lignocellulosic-based applications operating under harsh conditions.

Assessment of Primary Hemostasis by Platelet Function Analyzer-100 and its Relation with TSH and FT4 Levels in Newly Diagnosed Overt and Subclinical Hypothyroid Patients.

Various abnormalities of coagulation such as primary hemostasis, secondary hemostasis and fibrinolysis have been reported in patients with subclinical and overt hypothyroidism. Platelets are major elements of primary hemostasis and endothelial repair. Platelet size, shape and number are the determinant of platelet function. The objective of this study was to assess primary hemostasis by PFA-100 (Platelet Function Analyzer-100) and its relation with TSH and FT4 levels in newly diagnosed overt and subclinical hypothyroid patients. This cross-sectional study was conducted in the Department of Physiology, Dhaka Medical College, Bangladesh from January 2016 to December 2016. Twenty overt and 20 subclinical hypothyroid patients with age ranging from 18 to 55 years were selected as study group and twenty age and sex matched healthy subjects were considered as control group. Patients were selected from Outpatients Department of Endocrinology and Nuclear Medicine & Allied Sciences of Dhaka Medical College Hospital, Dhaka on the basis of exclusion and inclusion criteria. For assessment of primary hemostasis, PFA-100 was analyzed by SIEMENS-INNOVANCE-PFA-200. For statistical analysis Unpaired Student's 't' test, Chi square test and Pearson's correlation co-efficient (r) test were performed. PFA-100 was significantly higher (p<0.001) in overt and subclinical hypothyroid patients as compared to healthy adult subjects. In overt and subclinical hypothyroidism using PFA-100, we found that the existence of a hypocoagulable state is due to a defect in primary hemostasis. Moreover, PFA-100 may replace the in-vivo bleeding time as a screening test for primary hemostasis in routine clinical practice.

How Does Oversewing/Suturing (OS/S) Compare to Other Staple Line Reinforcement Methods? A Systematic Review and Meta-Analysis.

Various staple line reinforcement (SLR) techniques in sleeve gastrectomy, including oversewing/suturing (OS/S), gluing, and buttressing, have emerged to mitigate postoperative complications such as bleeding and leaks. A meta-analysis of randomized controlled trials has demonstrated OS/S as an efficacious strategy for preventing postoperative complications, encompassing leaks, bleeding, and reoperations. Given that OS/S is the sole SLR technique not incurring additional costs during surgery, our study aimed to compare postoperative outcomes associated with OS/S versus alternative SLR methods. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we reviewed the literature and conducted fifteen pairwise meta-analyses of comparative studies, each evaluating an outcome between OS/S and another SLR technique. Thirteen of these analyses showed no statistically significant differences, whereas two revealed notable distinctions.

Hernia repair in the bariatric patient: a systematic review and meta-analysis.

BACKGROUND: Repair options for ventral hernias in bariatric patients include performing a staged approach in which bariatric surgery is performed before definitive hernia repair (BS-first), a staged approach in which hernia repair is performed before bariatric surgery (HR-first), or a concomitant approach. OBJECTIVES: This meta-analysis aims to determine which surgical approach is best for bariatric patients with hernias. SETTING: PubMed, CENTRAL, and Embase databases. METHODS: A comprehensive search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to screen for all studies that focused on outcomes of patients who underwent both hernia repair and bariatric surgery, either simultaneously or separately. Exclusion criteria included hiatal and inguinal hernia studies, case reports, and case series. RESULTS: 27 studies fit our inclusion criteria after identifying 1584 studies initially. Seven comparative studies were included, enrolling 8548 staged patients (6458 BS-first) and 3528 concomitant patients. A total of 7 single-arm staged studies and 13 single-arm concomitant studies were also included. Data on hernia recurrence, mesh infection, reoperation, surgical site infections, seroma, bowel complications, and mortality were abstracted. The concomitant approach was associated with decreased odds of experiencing surgical site infections, reoperation, and seromas. The staged approach (BS-first) was associated with decreased odds of mesh infection. The single-arm studies suggest a lower incidence of hernia recurrence in a staged BS-first approach than in a concomitant approach. CONCLUSIONS: The data suggest a concomitant approach is appropriate for hernias that the surgeon feels do not require mesh, while the staged (BS-first) approach is more appropriate if the hernia requires mesh placement.

Measuring the effectiveness of an integrated intervention package to improve the level of infection prevention and control: a multi-centre study in Bangladesh.

BACKGROUND: Infection prevention and control (IPC) is a critical component of delivering safe, effective and high-quality healthcare services, and eliminating avoidable healthcare-associated infections (HAIs) in health facilities, predominantly in population-dense settings such as Bangladesh. AIM: Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh. METHODS: We conducted a pre-post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0-200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities. RESULTS: The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level. CONCLUSION: The integrated intervention package improved IPCAF score in all facilities.

Study on Blood Pressure, e-GFR, Serum Albumin, C-reactive Protein in Normal Subjects and Patients with CKD.

In general, Kidney diseases are silent with no apparent early symptoms and chronic kidney disease (CKD) is marked by gradual loss of kidney function over time. High rate of inflammation is common in CKD and it causes high CRP level. High CRP levels are associated with low e-GFR and low serum albumin level. This study was conducted to determine the changes of blood pressure, estimated glomerular filtration rate, serum albumin and C-reactive protein in chronic kidney diseased patients and compared with healthy subjects. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Bangladesh from July 2021 to June 2022. A total number of 140 subjects, age range between 25-70 years were included in this study. Among them, 70 healthy subjects were taken as control group (Group I) with 35 male (IA) and 35 female (IB) and 70 chronic kidney diseased patients were taken as study group (Group II) with 35 male (IIA) and 35 female (IIB). Calculation of estimated glomerular filtration rate (eGFR) was done by chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Data were expressed as mean±SD and statistical significance difference among the group were calculated by unpaired t-test. In this study, we found that eGFR (in IIA 29.83±0.73 ml/min and in IIB 30.80±0.73ml/min) and serum albumin (in IIA 2.96±0.04g/dl in IIB 2.07±0.02g/dl) were significantly decreased in study group in comparison to control group. Blood pressure (SBP in IIA 150.57±1.70 mm of Hg, in IIB 143.71±1.32 mm of Hg and DBP in IIA 94.40±0.70 and in IIB 91.20±0.70 mm of Hg) and C-reactive protein (CRP) (in IIA 12.14±0.90mg/l and in IIB 21.80±2.58mg/l) were significantly increased in study group in comparison to control group. CKD is associated with increased risks of several co-morbidities including cardiovascular complications and chronic renal failure. Detection of CKD at an early stage helps to reduce the progression of renal disease and burden of end stage renal disease.

Antral Preservation in Sleeve Gastrectomy Appears to Protect Against Prolonged Vomiting and Gastroesophageal Reflux Disease. A Meta-Analysis of Randomized Controlled Trials.

The optimal distance between the starting point of gastric transection and the pylorus during laparoscopic sleeve gastrectomy (LSG), which can be referred to as the distance from pylorus (DFP), is controversial. No consensus exist for what DFP is considered antral preservation, and what DFP is considered antral resection. Some surgeons prefer shorter DFP to maximize excess weight loss percentage (EWL%), while others prefer longer DFP because they believe that it shortens length of stay (LOS) and protects against leaks, prolonged vomiting, and gastroesophageal reflux disease (GERD). We sought to compare 6-cm DFP and 2-cm DFP in postoperative outcomes. In addition, we sought to evaluate the magnitude of any observed benefit through number needed to treat (NNT) analysis.

CO2 Adsorption on Pore-Engineered Carbons Derived from Jute Sticks.

CO2 capture is a practical approach to mitigating the impacts of global warming. Adsorption-based carbon capture is a clean and potentially energy-efficient method whose performance greatly depends on adsorbent design. In this study, we explored the use of jute-derived carbon as a high-performance adsorbent for CO2 capture. The carbons were produced by pyrolyzing powdered jute sticks with NaHCO3 as an activating agent at 500-700 °C. Impressive adsorption capacities of up to 2.5 mmol ⋅ g-1 and CO2 /N2 selectivities of up to 54 were achieved by adjusting the pore size distribution and surface functionalization. Based on the isotherm results, the working capacities, regenerabilities, and potentials for CO2 separation were determined for a practical vacuum swing adsorption process. The adsorbent materials were characterized by XRD, FTIR, Raman, FESEM and N2 sorption at 77 K. This study provides a general approach for designing adsorbents for various gas-separation applications.

Impact of Levothyroxine on Lipid Profile in Patients with Hypothyroidism.

Hypothyroidism is a common endocrine disorder and requires lifelong treatment. Hypothyroidism is often associated with dyslipidemia in some populations. The present study was designed to evaluate the impact of levothyroxine (LT4) on lipid profile in hypothyroid patients. This cross-sectional analytical study was conducted in the Department of Pharmacology & Therapeutics, Rajshahi Medical College in collaboration with the Institute of Nuclear Medicine and Allied Sciences (INMAS), Rajshahi from July 2018 to June 2019 to compare serum total cholesterol (TC), serum triglyceride (TG), serum LDL-C and serum HDL-C levels among euthyroids, newly diagnosed hypothyroid patients and levothyroxine (LT4) treated hypothyroid patients. A total of 30 patients with newly diagnosed hypothyroidism and an equal number of age-matched healthy controls (n=30, control group) of both sexes were recruited in the present study. Thirty (30) hypothyroid patients were reevaluated after 6 month of LT4 therapy. The fasting blood samples were collected from the subjects for the estimation of lipid profile. Significantly higher values were observed in total cholesterol (TC) 198.5±19.2mg/dl, triglycerides (TG) 147.0±14.5mg/dl, low density lipoprotein cholesterol (LDL-C) 133.9±19.7mg/dl (p<0.001) and a significant decreased value was seen in high density lipoprotein-cholesterol (HDL-C) levels (35.1±3.67mg/dl) in newly diagnosed hypothyroid patients as compared to after LT4 therapy and normal healthy individuals (p=0.009). These observations suggest that people with hypothyroidism have high risk of development of atherosclerosis which may lead to coronary heart diseases (CHD) due to persistent dyslipidemia. Hypothyroidism induces dyslipidemia or expedites the process of existing dyslipidemia, LT4 therapy corrects it to a significant level thus reduce the risk for atherosclerosis.

Oversewing/Suturing of the Staple Line During Sleeve Gastrectomy Is an Effective and Affordable Staple Line Reinforcement Method: a Meta-analysis of Randomized Controlled Trials.

Bleeding and leaks are the most ominous postoperative complications after laparoscopic sleeve gastrectomy (LSG). Various staple line reinforcement (SLR) techniques have been innovated such as oversewing/suturing (OS/S), omentopexy/gastropexy, buttressing, and gluing. Currently, no high-quality evidence supports the use of one method over the others or even supports the use of SLR over no SLR. This study aimed to compare postoperative outcomes between LSG with OS/S versus LSG without any SLR.

Design and operation of a hybrid LED/LD-pumped phosphor-converted white-light lamp.

Illumination sources based on phosphors, pumped by laser diodes (LDs), have seen rapid developments over the past decade. Here, we present a new, to the best of our knowledge, design that features both spectral richness and the capability for high brightness. Complete design details and operational characterization have been described. This basic design can be extended in various ways to customize such lamps for different operational requirements. A hybrid arrangement of both LEDs and an LD is used to excite a mixture of two phosphors. The LEDs, in addition, provide a blue fill-in to enrich output radiation and to tune the chromaticity point inside the white region. The LD power, on the other hand, can be scaled up to generate very high brightness levels that are not achievable with pumping from LEDs alone. This capability is gained using a special transparent ceramic disk that carries the remote phosphor film. We also show that the radiation from our lamp is free from speckle-producing coherence.

Seamguard Buttressing of the Staple Line During Laparoscopic Sleeve Gastrectomy Appears to Decrease the Incidence of Postoperative Bleeding, Leaks, and Reoperations. A Systematic Review and Meta-Analysis of Non-Randomized Comparative Studies.

Leaks and bleeding are major acute postoperative complications following laparoscopic sleeve gastrectomy (LSG). Various staple line reinforcement (SLR) methods have been invented such as oversewing/suturing (OS/S), omentopexy/gastropexy (OP/GP), gluing, and buttressing. However, many surgeons do not use any type of reinforcement. On the other hand, surgeons who use a reinforcement method are often confused of what kind of reinforcement they should use. No robust and high-quality data supports the use of one reinforcement over the other or even supports the use of reinforcement over no-reinforcement. Therefore, SLR is a controversial topic that is worth our focus. The aim of this study is to compare the outcomes of LSG with versus without Seamguard buttressing of the staple line during LSG.

Synthesis and antibacterial activity of nanoenhanced conjugate of Ag-doped ZnO nanorods with graphene oxide.

In this paper, we report a successful synthesis of ZnO nanorods using the microwave-assisted technique, solid-state reaction method was utilized for the preparation of Zn1-xAgxO (x = 0.05, 0.1), Hummer's modified method for graphene oxide (GO) along with the sonication method to prepare GO-based Ag-doped ZnO (Zn1-xAgxO/GO: x  = 0.05, 0.1) nanocomposites. These nanorods and nanocomposites were characterized by X-ray diffraction (XRD), Fourier-transform infrared (FTIR), high-resolution transmission electron microscopy (HRTEM), and Raman spectroscopy for structural properties, scanning electron microscopy (SEM) along with energy dispersive X-ray (EDX) spectroscopy for morphological analysis, and UV-Vis spectroscopy for optical properties. XRD, FTIR, and Raman measurements substantiated that each sample is well crystallized in the single-phase polycrystalline wurtzite hexagonal structure of ZnO. The average crystallite size is found to be in decreasing order ranges 40 nm to 29 nm, respectively, along with a significant reduction in the optical bandgap. The SEM images showed a clear evidence of nanorods of ZnO, while the EDX spectra verified the presence of Zn, Ag, O, and C elements in the synthesized samples with their nominal percentage. Furthermore, the prepared nanocomposites effectively inhibited the growth ofStaphylococcus aureus and Escherichia coli. In comparison to pure ZnO nanorods, GO-based Ag-doped ZnO nanorods showed improved antibacterial activity against both S. aureus and E. coli.