CT Body Composition of Sarcopenia and Sarcopenic Obesity: Predictors of Postoperative Complications and Survival in Patients with Locally Advanced Esophageal Adenocarcinoma.

BACKGROUND: To assess the impact of body composition imaging biomarkers in computed tomography (CT) on the perioperative morbidity and survival after surgery of patients with esophageal cancer (EC). METHODS: Eighty-five patients who underwent esophagectomy for locally advanced EC after neoadjuvant therapy between 2014 and 2019 were retrospectively enrolled. Pre- and postoperative CT scans were used to assess the body composition imaging biomarkers (visceral (VAT) and subcutaneous adipose tissue (SAT) areas, psoas muscle area (PMA) and volume (PMV), total abdominal muscle area (TAMA)). Sarcopenia was defined as lumbar skeletal muscle index (LSMI) ≤38.5 cm2/m2 in women and ≤52.4 cm2/m2 in men. Patients with a body mass index (BMI) of ≥30 were considered obese. These imaging biomarkers were correlated with major complications, anastomotic leakage, postoperative pneumonia, duration of postoperative hospitalization, disease-free survival (DFS), and overall survival (OS). RESULTS: Preoperatively, sarcopenia was identified in 58 patients (68.2%), and sarcopenic obesity was present in 7 patients (8.2%). Sarcopenic patients were found to have an elevated risk for the occurrence of major complications (OR: 2.587, p = 0.048) and prolonged hospitalization (32 d vs. 19 d, p = 0.040). Patients with sarcopenic obesity had a significantly higher risk for postoperative pneumonia (OR: 6.364 p = 0.018) and a longer postoperative hospital stay (71 d vs. 24 d, p = 0.021). Neither sarcopenia nor sarcopenic obesity was an independent risk factor for the occurrence of anastomotic leakage (p > 0.05). Low preoperative muscle biomarkers (PMA and PMV) and their decrease (ΔPMV and ΔTAMA) during the follow-up period significantly correlated with shorter DFS and OS (p = 0.005 to 0.048). CONCLUSION: CT body composition imaging biomarkers can identify high-risk patients with locally advanced esophageal cancer undergoing surgery. Sarcopenic patients have a higher risk of major complications, and patients with sarcopenic obesity are more prone to postoperative pneumonia. Sarcopenia and sarcopenic obesity are both subsequently associated with a prolonged hospitalization. Low preoperative muscle mass and its decrease during the postoperative follow-up are associated with lower DFS and OS.

Who's watching influences caching effort in wild Steller's jays (Cyanocitta stelleri).

Steller's jays (Cyanocitta stelleri) often store food and return to retrieve the stored items at a later time. Between caching and consumption, stored food has the potential to be pilfered by conspecific observers. We investigated whether individually marked Steller's jays in suburban neighborhoods of Arcata, California, USA, adjusted cache concealment effort when in the presence of conspecifics. Both male and female jays traveled the shortest distances to cache when alone, traveled further when a mate was present, and traveled furthest when neighbors from adjacent territories were present. These results suggest that Steller's jays recognize and respond to social contexts when concealing food items.

Steller sex: infidelity and sexual selection in a social Corvid (Cyanocitta stelleri).

Genetic analysis of avian mating systems has revealed that more than 70% of monogamous species show incidence of offspring parentage that does not match the social partner. Extra-pair parentage (EPP) has been linked to a variety of factors, including size and symmetry of ornamental traits, coloration, resource availability, and local conspecific density. We examined how ornamental plumage traits of individual Steller's jays (Cyanocitta stelleri) and territory characteristics influence genetic fidelity of socially monogamous pairs. We used seven highly polymorphic microsatellite markers to assign paternity to 79 offspring, and identified 12 (15.2%) as extra-pair young (EPY). Steller's jays with extra-pair young had significantly lower values of feather brightness and hue, indicating more ultraviolet-blue shifted coloration, and nested in closer proximity to the forest edge than Steller's jays with no detected EPY. Body size, crest height, asymmetry of ornamental crest stripes, as well as vegetative composition of territories and their proximity to supplemental feeders appeared to have little relationship to EPP. These results indicate that extra-pair parentage plays a role in the evolution of secondary sexual characteristics in both sexes, and suggest local density and availability of resources may influence Steller's jay mating dynamics.

Biaxial microincision versus coaxial small-incision clear cornea cataract surgery.

OBJECTIVE: To compare clinical outcomes of biaxial microincision (1.5 mm) and coaxial small-incision (2.75 mm) clear cornea cataract surgery. DESIGN: Randomized controlled clinical trial. PARTICIPANTS: Seventy eyes of 70 patients were examined at a German university eye hospital. INTERVENTION: The 70 patients (70 eyes) were assigned randomly (1:1) to a biaxial or conventional coaxial incision group. Both groups underwent phacoemulsification using pulsed ultrasound energy with variable duty cycles, followed by microincision intraocular lens implantation. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), astigmatism, laser flare photometry value, effective phacoemulsification time (EPT), and endothelial cell count were evaluated. RESULTS: The treatment groups did not differ in baseline characteristics (median BCVA of 20/40 preoperatively in both groups, P = 0.97). On postoperative day 1, BCVA was better in the biaxial group than in the coaxial group (20/25 vs. 20/33, P = 0.018). Eight weeks after surgery, median BCVAs were 20/20 in the biaxial group and 20/25 in the coaxial group (P = 0.015). Median changes in astigmatism were -0.15 diopters (D) in the biaxial group and -0.31 D in the coaxial group. Neither clinically relevant nor statistically significant differences were found in laser flare photometry values. Effective phacoemulsification time was >3 seconds in only 34% of biaxial procedures, versus 68% of coaxial procedures (P = 0.013). At 8 weeks after surgery, endothelial cell counts were decreased similarly in the biaxial (14.5%) and coaxial (14.1%) groups (P = 0.408). CONCLUSIONS: With the biaxial microincision technique, EPT is shorter and BCVA improves more rapidly, with no difference in astigmatism, laser flare photometry results, or endothelial cell count relative to the coaxial small-incision technique for phacoemulsification.