ABSTRACT Background Postoperative pancreatic fistula (POPF) is a common and serious complication following pancreatic surgery. While several studies have attempted to predict the development of POPF using drain amylase concentration, predictive values vary widely due to factors like abdominal irrigation and chylous drainage, which can dilute the amylase levels. This study aims to evaluate whether the “Real Amylase Value” (RAV), calculated as the product of drain amylase concentration and drainage volume, provides a more reliable prediction of POPF compared to conventional amylase concentration. Better prediction of pancreatic fistula development could lead to closer clinical monitoring of these patients, reassessment of hospital stay duration, and more careful management of drains over an extended period. Additionally, carefully managing the timing of drain removal may improve patient recovery and discharge process. Methodology Data from 198 patients who underwent pancreaticoduodenectomy (PD) and distal pancreatectomy (DP) were retrospectively analyzed. Drain amylase concentrations and drainage volumes were measured on postoperative days (POD) 1 and 3, and the RAV (U) was calculated. Real Amylase Value (RAV) (U) was calculated using the formula: RAV (U) = Drain Amylase Concentration (U/L) × Drainage Amount (L). Predictive values for POPF were evaluated using receiver operating characteristic (ROC) curve analysis, comparing conventional amylase concentration (U/L) and RAV (U). Results On POD1, the RAV (U) demonstrated greater predictive value for POPF compared to the conventional drain amylase concentration (U/L) with an area under the ROC curve (AUROC) of 0.85 versus 0.79, respectively. Similarly, on POD3, RAV showed superior predictive accuracy (AUROC 0.89) compared to amylase concentration (AUROC 0.79). Conclusion The RAV (U) offers a more accurate and reliable prediction of POPF than traditional drain amylase concentration (U/L), with improved sensitivity and specificity. This method could refine clinical management, particularly in the timing of drain removal and early intervention strategies for patients at high risk of developing pancreatic fistulas.
ABSTRACT Intellectual disability (ID) is defined as a severe impairment in reasoning, learning, and problem‐solving abilities along with adaptive behavior that occurs before the age of 18 years. The present study aimed to present the clinical and genetic data of a cohort of Turkish pediatric patients diagnosed with the ultrarare (which only up to 20 cases having been reported in the relevant literature thus far) ID phenotype. A total of 29 patients from 26 different families, who were diagnosed with ultrarare ID upon whole exome sequencing (WES) analysis, were included in the study. Of the patients included in the study, 18 (62%) were male and 11 (38%) were female. There was consanguinity between parents in 16 families (55%). With respect to the ID phenotype, three families had cases with a similar phenotype, while 23 families (88%) had sporadic cases. Upon molecular analysis, 28 different variations in 23 different genes were noted. Of the variations detected, 15 were missense, 6 nonsense, 4 frameshift, 2 splice‐site, and 1 gross exonic deletion. Nine (32%) variations were novel among the detected variations. This study summarized the clinical and genetic features of 23 different ultrarare ID phenotypes by means of WES study, including copy number variations (CNVs) analysis. Novel clinical and genetic findings in the present study contribute to a better understanding of the genotypic and phenotypic spectrum. The effects of some rare variations on protein structure were revealed by means of in silico modeling. Newly described cases with ultrarare phenotypes help achieve a clearer description of the clinical and genetic manifestations of the syndromes and gain a better understanding of the molecular mechanisms.
ABSTRACT This study employed fNIRS‐ and EEG‐hyperscanning to investigate the effects of task sharing, social presence, and mental workload on intrabrain and interbrain functional connectivity, and neurophysiological responses of dyads during a dual n‐back task. The findings indicated a positive correlation between the n‐back level and reaction times, heart rate, and PFC oxygenation, whereas task accuracy and heart rate variability decreased with difficulty. The effect of social presence was smaller than the effect of task difficulty, suggesting a lower level of mental workload during the social condition, possibly due to social facilitation. In the social condition, interbrain connectivity tended to decrease as task difficulty increased, indicating that partners could monitor each other's actions to the extent that task demands allowed. The intrabrain connectivity analysis showed a larger difference between individual and social sessions compared with the difference between own and coactor's go trials in the social session. Overall, the EEG‐ and fNIRS‐hyperscanning measures obtained during a dual n‐back task in this study provide evidence regarding the differential modulation of interbrain and intrabrain functional connectivity due to the copresence of another actor responding to the same stimulus to pursue a different goal and changes in task difficulty.
Abstract Inflammatory bowel disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC), is a major health problem on a global scale and its treatment is unsatisfactory. We aimed to investigate the effects of transauricular vagal nerve stimulation (tVNS) on inflammation in rats with IBD induced by trinitrobenzene sulfonic acid (TNBS). A total of 36 adult female Sprague–Dawley rats were given TNBS, or vehicle, and tVNS, or sham, every other day for 30 min for 10 days. Postmortem macroscopic and microscopic colon morphology were evaluated by histological staining. Additionally, IL‐1β, IL‐6, IL‐10, and TNF‐α cytokine levels in the colon and the brain were evaluated by immunohistochemistry and western blotting analysis. TNBS induced epithelial damage, inflammation, ulceration, and thickened mucosal layer in the colonic tissues. Administration of tVNS significantly ameliorated the severity of TNBS‐induced tissue damage and inflammatory response. TNBS also alters pro‐inflammatory and anti‐inflammatory balance in the brain tissue. TVNS application significantly suppressed the protein levels of pro‐inflammatory cytokines, namely IL‐1β, IL‐6, and TNF‐ α while augmenting the level of anti‐inflammatory cytokine IL‐10 in the colonic and the brain tissue. We have shown that TNBS‐mediated colonic inflammation and tissue damage are associated with neuroinflammatory responses in the brain tissue. Also demonstrated for the first time that neuroinflammatory response in the gut‐brain axis is suppressed by tVNS in the IBD model. Non‐invasive tVNS stands out as a new potential treatment option for types of IBD.