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Metformin usage is of a decreased chance of intense appendicitis throughout Taiwanese individuals along with diabetes type 2 mellitus.
A. craccivora colonized 14 species in five plant families. A. gossypii was the most polyphagous species colonizing 19 species in 11 plant families. A. gossypii, A. craccivora, A. nerii and S. see more ramulensis were found in both wet and dry seasons. Because of A. craccivora's prevalence and high incidences on understory weeds and host trees, sandalwood plantations were important reservoirs for aphid spread to wild and crop plant hosts growing in cultivated and uncultivated land. Alternative hosts growing in rural bushland, irrigation channel banks, vacant or fallow land, and orchard plantation understories also constituted significant aphid reservoirs. This study provides new knowledge of the ecology of aphid vector species not only in the ORIA but also in tropical northern Australia generally. It represents one of relatively few investigations on aphid ecology in tropical environments worldwide. V.BACKGROUND Stroke is a major complication following cardiac surgery causing increased morbidity and mortality. There are limited data on outcomes of patients with large vessel occlusion (LVO) following cardiac surgery. METHODS Patients who underwent index cardiac surgeries (as defined by the STS) from 2010 to 2017 were reviewed from a prospectively maintained database. All patients with neurologic deficits were identified and only patients with ischemic strokes were included. RESULTS A total of 10,250 underwent cardiac surgical procedures. Post-operative stroke with neurological deficits occurred in 221(2.16%) patients. Of these, 53 patients (24.0%) had large vessel occlusion (LVO). Patients who suffered a post-operative stroke were older and more likely to be female. These patients had a higher STS predicted mortality, longer bypass time, cross-clamp time, total ICU hours and total hospital stay. Operative mortality was significantly higher for patients that had post-operative stroke (14.93% vs 2.15%; p less then 0.0001). Kaplan-Meier survival estimates demonstrated worse survival for the LVO cohort at one-year (54.72% vs 75.00%; p=0.002). Predictors of stroke included increasing age, known cerebrovascular disease, diabetes, and emergent operative status. The most significant predictors of operative mortality included emergent operative status and NYHA stage IV heart failure. There was no difference in 30 day, 1 year and 5 year mortality between the intervention and the medically managed patients in the LVO cohort. CONCLUSIONS Stroke is a devastating complication following cardiac surgery, which increases operative morbidity and mortality. Stroke with LVO was associated with worse survival. However, early intervention did not impart a survival benefit. BACKGROUND Despite increases in female representation within the cardiothoracic surgical workforce and societal memberships, our previous work has demonstrated that, at the national level, women's roles have remained stagnant among conference presentations and leadership opportunities. In this study, we sought to identify if similar findings exist at the regional level, specifically within the Southern Thoracic Surgical Association (STSA). METHODS STSA Annual Meeting Program books from 2003, 2008, 2013, and 2018 were reviewed for women's representation among oral abstract authors, invited speakers, moderators, STSA leadership, and award recipients. Differences between the genders and time points were assessed with chi-squared analyses and t-tests, respectively. RESULTS In 2003, women accounted for 4/102 (3.9%) authors, including 2/51 (3.9%) presenting and 2/51 (3.9%) senior roles. From 2003 to 2018, increases in female authorship were observed, with 18/85 (21.2%) presenting and 13/85 (15.3%) senior author positions filled by women (p=0.017 and 0.072, respectively). Compared to men, women consistently accounted for fewer invited speakers (p less then 0.050 for all years). Although women represented fewer session moderators (p less then 0.050 for all years), a significant increase was observed over time, from 0/2 (0.0%) in 2003 to 18/105 (17.1%) in 2018 (p=0.009). Compared to 2003, women also increased significantly among STSA Committee members in 2018 (0/7 [0.0%] vs 6/40 [15.0%], p less then 0.001). CONCLUSIONS Over the last 15 years, women have been increasingly represented among STSA Annual Meeting presenting authors, session moderators, and Committee members. However, opportunity for greater emphasis on diversity and inclusion exists, particularly among invited speakers and STSA leadership. Mitral valve (MV) annuloplasty has been the gold standard for treatment of functional MV regurgitation (MR). However, annuloplasty for functional MR may cause augmented posterior leaflet tethering which results in functional anterior prolapse. Herein we added papillary muscle heads focalization for such patients. All separated papillary muscle heads are sutured together and the roots of chordae at each papillary muscle are unifocalized on both sides. Stiches are positioned at same distances from corresponding leaflet edges to adjust the height of leaflet edges in each segment. This is a simple and effective technique to correct for functional anterior prolapse after annuloplasty. BACKGROUND Guidelines outlining the role of surgical embolectomy for acute pulmonary embolism remain consensus based, however recent outcomes have improved compared to traditional experiences. The purpose of this study was to examine contemporary outcomes of patients treated for acute pulmonary embolism on a nationwide scale. METHODS Patients undergoing systemic thrombolysis, catheter-directed therapy, and surgical embolectomy for acute pulmonary embolism from 2010-2014 in the National Inpatient Sample were included. RESULTS A total 58,974 patients with acute pulmonary embolism were included. Of these, 33,553 were treated with systemic thrombolysis, 22,336 with catheter-directed therapy, and 3,085 underwent surgical embolectomy. Thrombolysis was the most common, with a substantial increase after 2012, while surgical volumes remained stable. The surgical group, compared to systemic thrombolysis and catheter-directed therapy, had more saddle emboli (22% vs. 10% vs. 10%) and were more frequently at severe risk of mortality (56% vs.
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