Comparison of the LigaSure™ bipolar vessel sealer to monopolar electrocoagulation for thoracoscopic lobectomy and lymphadenectomy: a prospective randomized controlled trial.

BACKGROUND: High-energy devices allow better vessel sealing compared with monopolar electrocautery and could improve the outcomes of surgical operations. The objective of the study was to compare tissue dissection by the LigaSure™ device with that by monopolar electrocoagulation for thoracoscopic lobectomy and lymphadenectomy. METHODS: This pragmatic, parallel group, prospective randomized controlled trial was funded by the Medtronic External Research Program (ISR-2016-10,756) and registered at www. CLINICALTRIALS: gov (NCT03125798). The study included patients aged 18 years or older, who had undergone thoracoscopic lobectomy with lymphadenectomy at the Department of Thoracic Surgery of Poznan University of Medical Sciences between May 3, 2018, and November 4, 2021. Using simple randomization, the patients were assigned to undergo tissue dissection with either the LigaSure device (study group) or monopolar electrocautery (control group). Participants and care givers, except operating surgeons, were blinded to group assignment. The primary outcome was postoperative chest drainage volume. Secondary outcomes were change of the esophageal temperature during subcarinal lymphadenectomy and C-reactive protein level 72 h after surgery. RESULTS: Study outcomes were analyzed in 107 patients in each group. We found no differences between the study and control groups in terms of chest drainage volume (550 vs. 600 mL, respectively; p = 0.315), changes in esophageal temperature (- 0.1 °C vs. - 0.1 °C, respectively; p = 0.784), and C-reactive protein levels (72.8 vs. 70.8 mg/L, respectively; p = 0.503). The mean numbers of lymph nodes removed were 12.9 (SD: 3.1; 95% CI, 12.4 to 13.5) in the study group and 11.6 (SD: 3.2; 95% CI, 11.0 to 12.2) in the control group (p < 0.001). CONCLUSIONS: The use of the LigaSure device did not allow to decrease the chest drainage volume, local thermal spread, and systemic inflammatory response. The number of lymph nodes removed was higher in patients operated with the LigaSure device, which indicated better quality of lymphadenectomy.

Growth portfolios buffer climate-linked environmental change in marine systems.

Large-scale, climate-induced synchrony in the productivity of fish populations is becoming more pronounced in the world's oceans. As synchrony increases, a population's "portfolio" of responses can be diminished, in turn reducing its resilience to strong perturbation. Here we argue that the costs and benefits of trait synchronization, such as the expression of growth rate, are context dependent. Contrary to prevailing views, synchrony among individuals could actually be beneficial for populations if growth synchrony increases during favorable conditions, and then declines under poor conditions when a broader portfolio of responses could be useful. Importantly, growth synchrony among individuals within populations has seldom been measured, despite well-documented evidence of synchrony across populations. Here, we used century-scale time series of annual otolith growth to test for changes in growth synchronization among individuals within multiple populations of a marine keystone species (Atlantic cod, Gadus morhua). On the basis of 74,662 annual growth increments recorded in 13,749 otoliths, we detected a rising conformity in long-term growth rates within five northeast Atlantic cod populations in response to both favorable growth conditions and a large-scale, multidecadal mode of climate variability similar to the East Atlantic Pattern. The within-population synchrony was distinct from the across-population synchrony commonly reported for large-scale environmental drivers. Climate-linked, among-individual growth synchrony was also identified in other Northeast Atlantic pelagic, deep-sea and bivalve species. We hypothesize that growth synchrony in good years and growth asynchrony in poorer years reflects adaptive trait optimization and bet hedging, respectively, that could confer an unexpected, but pervasive and stabilizing, impact on marine population productivity in response to large-scale environmental change.

Raised seasonal temperatures reinforce autumn Varroa destructor infestation in honey bee colonies.

Varroa destructor is the main pest of the honey bee Apis mellifera, causing colony losses. We investigated the effect of temperature on the autumn abundance of V. destructor in bee colonies over 1991-2020 in Central Europe. We tested the hypothesis that temperature can affect autumn mite populations with different time-lags modulating the bee abundance and brood availability. We showed that raised spring (March-May) and autumn (October) temperatures reinforce autumn V. destructor infestation in the bee colonies. The critical temperature signals embrace periods of bee activity, i.e., just after the first cleansing flights and just before the last observed bee flights, but no direct effects of phenological changes on V. destructor abundance were found. These effects were potentially associated with increased bee reproduction in the specific periods of the year and not with the extended period of activity or accelerated spring onset. We found significant effects of autumn bee abundance, autumn capped brood abundance, and the number of colonies merged on autumn mite infestation. We also observed differences in V. destructor abundance between bees derived from different subspecies. We indicated that climatic effects, through influence on the bee abundance and brood availability, are one of the main drivers regulating V. destructor abundance.

Otolith "spawning zones" across multiple Atlantic cod populations: Do they accurately record maturity and spawning?

Specific changes identified in the otolith macrostructure of Northeast Arctic cod as "spawning zones" are presumed to represent spawning events, but recent experimental studies have challenged this relationship. Because these zones are not routinely recorded outside of Norway, otoliths from multiple Atlantic cod populations with different life history and environmental traits were first examined to see if spawning zones could be identified as a general characteristic of cod. Then, a large archival collection of cod otoliths was used to investigate temporal changes in the occurrence of spawning zones and test for correlations between maturity at age derived from otolith spawning zones and gonad maturity stages. This study shows that spawning zones likely are a universal trait of Atlantic cod and not limited to certain environments or migratory behaviors as previously proposed. Maturity at age derived from spawning zone data showed trends consistent with those from gonad examinations. However, spawning zones appear to form with a one- or two-year lag with sexual maturity, which is suspected to reflect a stabilizing of energy partitioning after the first spawning events. Our results illustrate the potential for use of spawning zones, for example in species or populations with limited available maturity data, and highlights the need for addressing the physiological processes behind their formation.

Higher growth variability and stronger responses to temperature changes in wild than hatchery-reared sea trout (Salmo trutta L.).

Each year, millions of hatchery-reared sea-run brown trout Salmo trutta L. (the sea trout) juveniles are released into the natural environment in the Atlantic region. The aim of this work was to investigate the growth responses of sea trout to changing temperature conditions and to compare the growth plasticity between wild and hatchery-reared fish. Scales were collected from sea trout in a selected river flowing into the southern Baltic Sea. We analyzed the scale increment widths as a proxy of somatic growth and investigated the interannual variabilities and differences in growth between fish groups (wild and hatchery-reared). We used mixed-effects Bayesian modeling and ascribed the variances in growth to different sources. Furthermore, we developed indices of interannual (2003-2015) growth variation in the marine and freshwater phases of the life cycle of the fish and analyzed the relationships between trout growth and temperature. Temperature positively affects fish growth, regardless of the origin of the fish. We observed stronger relationships between fish growth and temperature conditions in the marine phase than in the freshwater phase. Additionally, wild sea trout are characterized by stronger responses to temperature variability and higher phenotypic plasticity of growth than those of the hatchery-reared individuals. Therefore, wild sea trout might be better suited to changing environmental conditions than hatchery-reared sea trout. This knowledge identifies possible threats in management actions for sea trout with an emphasis on ongoing climate change.

Differences in metabolic rate between two Atlantic cod (Gadus morhua) populations estimated with carbon isotopic composition in otoliths.

The isotopic composition of inorganic carbon in otoliths (δ13Coto) can be a useful tracer of metabolic rates and a method to study ecophysiology in wild fish. We evaluated environmental and physiological sources of δ13Coto variation in Icelandic and Northeast Arctic (NEA) cod (Gadus morhua) over the years 1914-2013. Individual annual growth increments of otoliths formed at age 3 and 8 were micromilled and measured by isotope-ratio mass spectrometry. Simultaneously, all annual increment widths of the otoliths were measured providing a proxy of fish somatic growth. We hypothesized that changes in the physiological state of the organism, reflected by the isotopic composition of otoliths, can affect the growth rate. Using univariate and multivariate mixed-effects models we estimated conditional correlations between carbon isotopic composition and growth of fish at different levels (within individuals, between individuals, and between years), controlling for intrinsic and extrinsic effects on both otolith measurements. δ13Coto was correlated with growth within individuals and between years, which was attributed to the intrinsic effects (fish age or total length). There was no significant correlation between δ13Coto and growth between individuals, which suggests that caution is needed when interpreting δ13Coto signals. We found a significant decrease in δ13Coto through the century which was explained by the oceanic Suess effect-admixture of isotopically light carbon from fossil fuel. We calculated the proportion of the respired carbon in otolith carbonate (Cresp) using carbon isotopic composition in diet and dissolved inorganic carbon of the seawater. This approach allowed us to correct the values for each stock in relation to these two environmental baselines. Cresp was on average 0.275 and 0.295 in Icelandic and NEA stock, respectively. Our results provide an insight into the physiological basis for differences in growth characteristics between these two cod stocks, and how that may vary over time.

Contrasting patterns in the occurrence and biomass centers of gravity among fish and macroinvertebrates in a continental shelf ecosystem.

The distribution of a group of fish and macroinvertebrates (n = 52) resident in the US Northeast Shelf large marine ecosystem were characterized with species distribution models (SDM), which in turn were used to estimate occurrence and biomass center of gravity (COG). The SDMs were fit using random forest machine learning and were informed with a range of physical and biological variables. The estimated probability of occurrence and biomass from the models provided the weightings to determine depth, distance to the coast, and along-shelf distance COG. The COGs of occupancy and biomass habitat tended to be separated by distances averaging 50 km, which approximates half of the minor axis of the subject ecosystem. During the study period (1978-2018), the biomass COG has tended to shift to further offshore positions whereas occupancy habitat has stayed at a regular spacing from the coastline. Both habitat types have shifted their along-shelf distances, indicating a general movement to higher latitude or to the Northeast for this ecosystem. However, biomass tended to occur at lower latitudes in the spring and higher latitude in the fall in a response to seasonal conditions. Distribution of habitat in relation to depth reveals a divergence in response with occupancy habitat shallowing over time and biomass habitat distributing in progressively deeper water. These results suggest that climate forced change in distribution will differentially affect occurrence and biomass of marine taxa, which will likely affect the organization of ecosystems and the manner in which human populations utilize marine resources.

Century-long cod otolith biochronology reveals individual growth plasticity in response to temperature.

Otolith biochronologies combine growth records from individual fish to produce long-term growth sequences, which can help to disentangle individual from population-level responses to environmental variability. This study assessed individual thermal plasticity of Atlantic cod (Gadus morhua) growth in Icelandic waters based on measurements of otolith increments. We applied linear mixed-effects models and developed a century-long growth biochronology (1908-2014). We demonstrated interannual and cohort-specific changes in the growth of Icelandic cod over the last century which were mainly driven by temperature variation. Temperature had contrasting relationships with growth-positive for the fish during the youngest ages and negative during the oldest ages. We decomposed the effects of temperature on growth observed at the population level into within-individual effects and among-individual effects and detected significant individual variation in the thermal plasticity of growth. Variance in the individual plasticity differed across cohorts and may be related to the mean environmental conditions experienced by the group. Our results underscore the complexity of the relationships between climatic conditions and the growth of fish at both the population and individual level, and highlight the need to distinguish between average population responses and growth plasticity of the individuals for accurate growth predictions.

A century of fish growth in relation to climate change, population dynamics and exploitation.

Marine ecosystems, particularly in high-latitude regions such as the Arctic, have been significantly affected by human activities and contributions to climate change. Evaluating how fish populations responded to past changes in their environment is helpful for evaluating their future patterns, but is often hindered by the lack of long-term biological data available. Using otolith increments of Northeast Arctic cod (Gadus morhua) as a proxy for individual growth, we developed a century-scale biochronology (1924-2014) based on the measurements of 3,894 fish, which revealed significant variations in cod growth over the last 91 years. We combined mixed-effect modeling and path analysis to relate these growth variations to selected climate, population and fishing-related factors. Cod growth was negatively related to cod population size and positively related to capelin population size, one of the most important prey items. This suggests that density-dependent effects are the main source of growth variability due to competition for resources and cannibalism. Growth was also positively correlated with warming sea temperatures but negatively correlated with the Atlantic Multidecadal Oscillation, suggesting contrasting effects of climate warming at different spatial scales. Fishing pressure had a significant but weak negative direct impact on growth. Additionally, path analysis revealed that the selected growth factors were interrelated. Capelin biomass was positively related to sea temperature and negatively influenced by herring biomass, while cod biomass was mainly driven by fishing mortality. Together, these results give a better understanding of how multiple interacting factors have shaped cod growth throughout a century, both directly and indirectly.

Cascading effects of temperature alterations on trophic ecology of European grayling (Thymallus thymallus).

The aims of this project were to study: diet composition, food selectivity and the phenology of different prey items in grayling's (Thymallus thymallus) diet. It was hypothesized, that alterations in mayfly emergence, caused by reservoir-induced thermal changes, have consequences for trophic ecology of drift-feeding fish. Sampling of fish and macroinvertebrates were conducted in two closely located rivers, one human-modified and the other an undisturbed river. Grayling preyed mainly on aquatic insects, but only mayflies were preferred. Seasonal changes of the fish diet were observed, and air temperature is considered a predictor of prey occurrence with different time lags, depending on the biology of the organisms. Significant differences in the abundances and probability of mayfly occurrence between two studied rivers were shown. The observed phenological shift suggests that distorted environmental cues were experienced by the Ephemeroptera in the modified river. The "lost generation" of insects which failed to complete development became a new food for fish. The results presented indicate that reservoir-induced thermal alterations in the rivers, similarly to climate change, can lead to a chain of consequences in the ecosystems. Taking into consideration the projected climate scenarios, further monitoring and forecasting of these effects are considered an important step for future mitigating actions and adaptive management of water resources.

Analyzing Effectiveness of Routine Pleural Drainage After Nuss Procedure: A Randomized Study.

BACKGROUND: The routine use of postoperative pleural cavity drainage after the Nuss procedure is not widely accepted, and its limited use depends on experience. This study analyzed the influence of pleural drainage in the surgical treatment of patients with pectus excavatum on the prevention of pneumothorax and the efficacy of using drainage after a corrective operation. METHODS: From November 2013 to May 2015, 103 consecutive patients with pectus excavatum, aged 11 to 39 years, underwent surgical treatment by the Nuss procedure. Patients were prospectively randomized into two groups. In 58 patients, a 28F chest tube was routinely introduced into the right pleural cavity during procedure for 2 consecutive days (group I). In the remaining 45 patients, the drain was not inserted (group II). RESULTS: No statistically significant differences were found between the study groups, including sex, age, body mass index, or clinical subjective and objective factors in the preoperative evaluation. Group II manifested more complications in the early postoperative period; however, this was not statistically significant (group I vs group II; p = 0.0725). Pneumothorax requiring additional chest tube placement was statistically significant (group I vs group II; p = 0.0230). Other complications were also more frequent among patients from group II, although this did not reach statistical significance. Follow up was 22.9 ± 6.4 months. CONCLUSIONS: Routine drainage of the pleural cavity during the Nuss procedure significantly reduces the incidence of postoperative pneumothorax and should be considered as a routine procedure.

Management of enteroatmospheric fistula with negative pressure wound therapy in open abdomen treatment: a multicentre observational study.

The management of enteroatmospheric fistula (EAF) in open abdomen (OA) therapy is challenging and associated with a high mortality rate. The introduction of negative pressure wound therapy (NPWT) in open abdomen management significantly improved the healing process and increased spontaneous fistula closure. Retrospectively, we analysed 16 patients with a total of 31 enteroatmospheric fistulas in open abdomen management who were treated using NPWT in four referral centres between 2004 and 2014. EAFs were diagnosed based on clinical examination and confirmed with imaging studies and classified into low (<200 ml/day), moderate (200-500 ml/day) and high (>500 ml/day) output fistulas. The study group consisted of five women and 11 men with the mean age of 52·6 years [standard deviation (SD) 11·9]. Since open abdomen management was implemented, the mean number of re-surgeries was 3·7 (SD 2·2). There were 24 EAFs located in the small bowel, while four were located in the colon. In three patients, EAF occurred at the anastomotic site. Thirteen fistulas were classified as low output (41·9%), two as moderate (6·5%) and 16 as high output fistulas (51·6%). The overall closure rate was 61·3%, with a mean time of 46·7 days (SD 43·4). In the remaining patients in whom fistula closure was not achieved (n = 12), a protruding mucosa was present. Analysing the cycle of negative pressure therapy, we surprisingly found that the spontaneous closure rate was 70% (7 of 10 EAFs) using intermittent setting of negative pressure, whereas in the group of patients treated with continuous pressure, 57% of EAFs closed spontaneously (12 of 21 EAFs). The mean number of NPWT dressing was 9 (SD 3·3; range 4-16). In two patients, we observed new fistulas that appeared during NPWT. Three patients died during therapy as a result of multi-organ failure. NPWT is a safe and efficient method characterised by a high spontaneous closure rate. However, in patients with mucosal protrusion of the EAFs, spontaneous closure appears to be impossible to achieve.

A fish-based index for assessing the ecological status of Polish transitional and coastal waters.

Fish assemblages are considered indicators of aquatic ecosystem quality. Based on how fish communities respond to anthropogenic pressures, we developed a multimetric fish index for evaluating the health of both coastal and transitional waters. Fish data were collected along the Polish coast in the years 2011, 2013 and 2014 using different types of gear. Redundancy analysis showed that the most important environmental factor affecting fish community was salinity. Responses to anthropogenic disturbances of 20 candidate metrics were tested by generalized linear models, taking into account salinity, sampling protocol and the proxy of human pressures described by the Baltic Sea Impact Index (BSII). Five selected metrics were combined in a Multimetric Index, which showed negative significant correlation with BSII. The index presented herein appeared to be a good tool for assessing the ecological state of highly impacted Polish transitional and coastal areas and complies with the Water Framework Directive requirements.

Partial thyroidectomy under local anaesthesia-the analysis of 49 subsequent cases.

BACKGROUND AND AIMS: Partial thyroidectomy under local anaesthesia was performed in 49 subsequent individuals in the Central African Republic. Because of the shortage of medical resources, all patients with goitre were scheduled for an operation under local anaesthesia. MATERIALS AND METHODS: There were no inclusion or exclusion criteria applied for patient selection for the procedure. Before the operation, patients had received an oral sedation and antibiotic. For infiltration anaesthesia, 1% lignocaine was used. RESULTS: Subtotal bilateral thyroidectomy was performed in 37 patients; 12 patients underwent lobectomy or partial lobectomy of the affected portion of the gland. There were no intraoperative complications in any of the patients. The mean time of the procedure averaged 127 min. There were no postoperative complications noticed in the reported group, and this includes also complications related to laryngeal nerve injury. General condition of the operated on patients allowed for full self-dependency within 4 to 6 h postoperatively. Patients remained under medical surveillance for mean 3 days, and cutaneous stitches were removed on the first postoperative day. General condition of all patients on the day of discharge from hospital was good. CONCLUSION: Surgery for goitre under local anaesthesia may be a safe alternative where general anaesthesia is not available or contraindicated for medical reasons.