Background The coronavirus disease 2019 (COVID-19) pandemic led to a worldwide suspension of bariatric and metabolic surgery (BMS) services. The current study analyses data on patterns of service delivery, recovery of practices, and protective measures taken during the COVID-19 pandemic by bariatric teams. Materials and Methods The current study is a subset analysis of the GENEVA study which was an international cohort study between 01/05/2020 and 31/10/2020. Data were specifically analysed regarding the timing of BMS suspension, patterns of service recovery, and precautionary measures deployed. Results A total of 527 surgeons from 439 hospitals in 64 countries submitted data regarding their practices and handling of the pandemic. Smaller hospitals (with less than 200 beds) were able to restart BMS programmes more rapidly (time to BMS restart 60.8 ± 38.9 days) than larger institutions (over 2000 beds) (81.3 ± 30.5 days) (p = 0.032). There was a significant difference in the time interval between cessation/reduction and restart of bariatric services between government-funded practices (97.1 ± 76.2 days), combination practices (84.4 ± 47.9 days), and private practices (58.5 ± 38.3 days) (p < 0.001). Precautionary measures adopted included patient segregation, utilisation of personal protective equipment, and preoperative testing. Following service recovery, 40% of the surgeons operated with a reduced capacity. Twenty-two percent gave priority to long waiters, 15.4% gave priority to uncontrolled diabetics, and 7.6% prioritised patients requiring organ transplantation. Conclusion This study provides global, real-world data regarding the recovery of BMS services following the COVID-19 pandemic. Graphical abstract

The present paper focuses on a classic hyperacuity, Vernier acuitythe ability to discriminate breaks in the collinearity of lines or edges on the order of only arcseconds of visual angle. We measured steady-state sweep visual evoked potentials (sVEPs) in response to 6 Hz periodic breaks in collinearity (Vernier offsets) in horizontal squarewave gratings. Vernier thresholds, estimated by extrapolating the amplitude of the first harmonic (1F) to 0 μV, were measured for gratings with 4%, 8%, 16%, 32%, 64%, and 80% contrast, with gaps of 0, 2, or 5 arcmin introduced between neighboring bar elements that formed the Vernier offsets. Thresholds for the 2F response component provided an estimate of motion thresholds. The data confirmed and extended evidence that the odd-and even-harmonic components reflect cortical activity of different neurons (i.e., neurons that respond asymmetrically to the periodic breaks in alignment and neurons that respond symmetrically to the local relative motion cue of the stimulus). Suprathreshold data (peak amplitude, response slope, and response phase at the peak amplitude) provided additional independent evidence of this notion. Vernier thresholds decreased linearly as contrast increased, with a slope of approximately -0.5 on log-log axes, similar to prior psychophysical results. The form of contrast dependence showed more similarity to measures of magnocellular ganglion cell spatial precision than measures from parvocellular ganglion cells. Our data thus support the hypothesis that magnocellular ganglion cell output from the retina has the requisite properties to support cortical calculation of Vernier offsets at a hyperacuity level.

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