bluuebunny/crossref_metadata_2025_split huggingface dataset:
TECHNOLOGICAL BARRIERS OF LATINAMERICAN SURGICAL TRAINING CENTERS IN TIMES OF PANDEMIC: EXPERIENCES IN LOW RESOURCE ENVIRONMENTS
Authors: Reyes Monasterio A R , Cabrera Vargas L F , Reyes Herrera T , Acevedo Parrales J D 
Published: May 2021

Abstract

INTRODUCTION
In 2020, the SARS-CoV-2 / COVID-19 pandemic merited the reorganization of health institutions. It was necessary to suspend a large number of elective surgical procedures. For this reason, many surgical programs adopted new education measures such as simulation and virtual meetings. However, the reality in low- and middle-income countries is very different; so these initiatives could be challenging.

MATERIAL AND METHODS
It was an observational, descriptive, cross-sectional study. During the period from March 1 to December 31, 2020. 4 Latin American countries (Colombia, Mexico, Nicaragua and Venezuela) with a representative for each country. A survey was conducted in general surgery residents in order to assess the surgical education modalities used by training institutions to adapt the challenges of the SARS-CoV-2 / COVID-19 pandemic.

RESULTS
63 residents were evaluated. 32% dońt have internet access from home. 44% dońt have access to the internet in their training centers. 52% of residents deny using any social media to support the learning process. 90% have access to a personal smart device. 79% dońt have access to any simulation system to complement their training.

CONCLUSION
The internet access, the use of social media and simulation continues to be barriers to the learning process in times of pandemic in Latin American surgical residents.
3-D TECHNOLOGY & PEDIATRIC SURGERY: IBERO-AMERICAN SURVEY
Authors: Siles Hinojosa A , Roldón Golet M , Zabala Travers S , Hernández del Arco S 
Published: May 2021

Abstract

INTRODUCTION
The aim of this study is to evaluate the status and difficulty of 3-D technology implantation in the Ibero-American pediatric surgical field and to assess the opinion of medical professionals.

MATERIAL AND METHODS
Descriptive study of the results of an online survey conducted through google forms platform.

RESULTS
217 physicians from 15 countries answered the survey: 72.8% surgeons, 14.3% radiologists and others (12.9%). The majority (59%) do not have 3-D technology. Among those who used it (35.9%), 32.1% have worked with 3-D printing, 22.9% in virtual surgical planning and 15.6% with design and printing of customized surgical guides. Only 14.3% of the respondents received specific training; the majority know the technology through conversations with colleagues (39.2%) and attendance at medical conferences (45.6%). According to the pediatric surgeons who answered the survey, the areas that could benefit most from the use of 3-D are oncological surgery (56.4%), thoracic (49.5%) and hepatobiliary (42.7%). Lack of financial support (67%), ignorance (59.6%) and lack of human resources (46.8%) are considered the main difficulties of implantation. Most of the respondents agree that 3-D anatomical models have a positive impact on patient's ability to understand the disease (87.5%) and the risks of the surgical procedure (88%).

CONCLUSION
The implantation of 3-D technology in the Ibero-American pediatric surgical field is still limited and its causes are multiple. Despite this, professionals consider that this technological inclusion would have a positive impact on their clinical practice.
RESULTS OF LUNG TRANSPLANTATION ASSISTED WITH EXTRACORPOREAL MEMBRANE OXYGENATOR (ECMO)
Authors: Burgos Lázaro R J , Burgos Frías N , Rivas Oyarzabal J , Sánchez Calle A , Macías Sotuel A , Campo Cañaberal J L , Forteza Gil A , Varela Ugarte A 
Published: May 2021

Abstract

INTRODUCTION
According to the registry of the “International Society for Heart and Lung Transplantation” (ISHLT), 32% of lung transplants (Tx P) will require respiratory assistance in the perioperative period. The aim of the study is to compare the results of the Tx P that required ECMO, versus those that did not require respiratory assistance.

MATERIAL AND METHODS
Between January 2015 and December 31th 2018, 184 lung transplants were performed in the organ transplant unit. In 119 (64.7%) of the transplants, they did not need respiratory assistance and in 65 (35.3%) they required ECMO either intraoperatively and/or postoperatively. The indications for lung transplantation were: interstitial fibrosis 77 (41.8%), pulmonary emphysema 64 (34.7%), cystic fibrosis 28 (15.3%), others 15 (8.2%).

RESULTS
Patients with Mean Pulmonary Pressure (MPP) greater than 54 mmHg required assistance with ECMO during transplantation (p &lt; 0.03). 83% of transplanted patients remained in NYHA grade I and grade II. Hospital mortality was 21/184 (11.4%); ECMO mortality 14/67 (20.9%) vs NO-ECMO mortality 6/117 (5.1%), significantly higher (p &lt; 0.005 OR = 4.98). Survival and quality of life at 5 years were similar in both groups (p = 0.09).

CONCLUSIONS
ECMO has proven to be safe and effective in Tx P. Patients with PMP&gt; 54 mmHg required ECMO (p &lt; 0.03). After the hospital postoperative period, the quality of life and survival at five years were similar in both groups.
PERITONEAL DIALYSIS, A MEDICAL-SURGICAL COLLABORATION, DO WE OFFER QUALITY STANDARDS?
Authors: Llosa Pérez J , Michi Campos J L , Rodicio Miravalles J L , Astudillo Cortés E , Bande Fernández J , Rodríguez Suárez C , López-Negrete Cueto E , Granero Trancón J E 
Published: May 2021

Abstract

INTRODUCTION
Peritoneal dialysis is one of the renal replacement therapy options for patients with advanced chronic kidney disease. It provides an improvement in quality of life since it is practiced at home once a previous training has been completed, waiting for kidney transplant or if the patient is not a candidate for it.

MATERIAL AND METHODS
Between January 2014 and December 2017, an observational, descriptive, longitudinal and retrospective study was performed with 211 patients treated with peritoneal dialysis in a tertiary level hospital. In a 2-year follow-up, the complications, results and situation of peritoneal dialysis were analyzed, providing solutions for a better quality of patient care. Clinical and surgical variables were collected.

RESULTS
Survival of the first and second catheters was greater than 12 months in 79.5% and 86.2% of the patients, respectively. In the first 30 days after catheter placement, 4.7% of the patients had peritonitis. In no case was there visceral damage during surgery, nor was a reoperation required during the immediate postoperative period. Neither postoperative transfusions were needed nor were there leaks. The most important cause of end of technique (34.1%) was receiving a kidney transplant.

CONCLUSIONS
The peritoneal dialysis technique can be considered a good medical-surgical collaboration, since, in addition to complying with the established quality standards regarding this treatment, it is self-sufficient and effective as a renal replacement treatment in patients with advanced chronic kidney disease.
EFFECT OF TEMPERATURE ON THE MECHANICAL BEHAVIOR OF THE HUMAN AORTA AND CAROTID ARTERIES
Authors: Burgos Frías N , Burgos Lázaro R J , Rivas Oyarzabal J , Ospina Mosquera V , Rojo Pérez F , Atienza Riera J M , Forteza Gil A , Guinea Tortuero G 
Published: May 2021

Abstract

INTRODUCTION
Temperature affects the mechanical behavior of the arteries, a fact that intervenes in their function, both in physiology and in pathological states. The aim of the study is to analyze the mechanical response in the arteries (aorta and carotids) to changes in temperature.

MATERIAL AND METHODS
The thermo-mechanical behavior of human arteries (26 primitive carotids and 26 thoracic aortas) from cadaveric organ donors has been studied. The tests were carried out in a passive state, without electrical or chemical activation of the vessels. Pressurization tests were carried out at 4 different temperatures (17, 27, 37 and 42ºC) correlating internal pressure-external diameter of the vessels. The thermo-mechanical analysis was evaluated using the pressure-diameter curves at different temperatures, for this the coefficient of thermal expansion (α = (ΔD / D) / ΔT) and the Hayashi stiffness (β), exponential equation (Pressure / Diameter ratio).

RESULTS
The effect of temperature on arterial behavior is maximum when the curves refer to the initial diameter of the vessel at 0 mmHg for each temperature. At low pressures, the coefficient of dilation is negative, while above a certain threshold pressure (different for each type of artery), the coefficient of dilation becomes positive.

CONCLUSIONS
The stiffness of the vessels is manifested in the slope of the pressure-diameter curves and decreases with increasing temperature. The coefficient of thermal expansion is a function of the internal pressure to which the arteries are subjected.
TUNNELED LAPAROSCOPIC PERITONEAL DIALYSIS CATHETER AS A RESOURCE TECHNIQUE IN PERITONEAL DIALYSIS
Authors: Díaz Vico T , Rodicio Miravalles J L , Suárez Sánchez A , García Munar M , Carrasco Aguilera B , del Val Ruiz P , Amoza Pais S , Sanz Álvarez L M 
Published: May 2021

Abstract

INTRODUCTION
Surgical approach to peritoneal dialysis (PD) catheters is the main step in achieving successful PD therapy. It is important to conduct a simple and safe procedure, with adequate visualization of the path and location of the catheter, to avoid discontinuation of PD. The tunneled laparoscopic PD catheter (TLPDC) is a reliable surgical alternative in patients who are candidates for PD.

MATERIAL AND METHODS
This is a retrospective and descriptive study that includes all the patients in whom TLPDC was placed from October 2019 to January 2021. The objective is to know the rate of functioning and evaluate the complications derived from the procedure.

RESULTS
TLPDC was placed in 7 patients with a mean age of 51.4 (7.7) years and a mean BMI of 26.6 (8.0) kg/m2. Rescue therapy was considered in 6 (85.7%) patients, after removal of a previous PD catheter. There was no case (0.0%) of displacement, being the adequate functioning rate of 85.7%. One (14.3%) case of bacterial peritonitis was diagnosed, resolved with conservative management, and early TLPDC dysfunction in another (14.3%) case, requiring laparoscopic revision on the eleventh postoperative day and its repositioning, with current suspicion of encapsulating peritonitis.

CONCLUSIONS
The TLPDC approach is a safe and simple technique, avoiding displacement of the catheter and, thus, a higher success rate. However, as a counterpoint, it requires general anesthesia to be performed. Furthermore, an adequate selection of a suitable candidate for PD is necessary to ensure the success of the procedure.
RESULTS OF HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY AND CYTOREDUCTIVE SURGERY FOR PERITONEAL CARCINOMATOSIS OF COLORECTAL ORIGIN
Authors: Merayo Alvarez M , Turienzo Santos E , García Munar M , Cifrián Canales I , Rodicio Miravalles J L , Moreno Gijón M , Sanz Alvarez L 
Published: May 2021

Abstract

INTRODUCTION
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is supported by clinical practice and published series as a fundamental treatment for increasing survival of selected patients with colorectal peritoneal carcinomatosis. The results were evaluated since having implemented a peritoneal oncological surgery program five years ago.

MATERIAL AND METHODS
Descriptive analysis was conducted to patients who had been diagnosed with peritoneal carcinomatosis from May 2014 to December 2020. 36 out of 100 patients who had undergone surgery were included in the CRS and HIPEC assessment and 6 patients without HIPEC, were excluded.

RESULTS
The mean preoperative PCI was 7.81±6.61 accomplishing complete cytoreduction CC 0-CC-1 in the 36 cases. An average of 1.86±1.22 peritonectomies were performed. Among procedures, complete pelviperitonectomy (11 patients) and liver metastasis resection (6 patients) should be noticed. Complications were presented in 16 patients (8 patients over Clavien Dindo&gt;III) and 6 required reinterventions due to hematoma (2) or anastomotic leak (2) mostly. The 4-year overall survival is 76.2% and the disease-free interval is 34 months within an average follow-up of 23 months.

CONCLUSIONS
The overall survival and disease-free interval rates are above the standards. Currently, peritoneal carcinomatosis might be considered a curative disease. The multidisciplinary assessment allows selecting patients who will benefit from surgery.
INFLUENCE OF COVID-19 IN ACUTE APPENDICITIS
Authors: Arango Bravo A , Mateos Palacios C , Pérez Prudencio E , Soto Dopazo M , Nuño Iglesias C , Álvarez Laso C J , Sosa Rodríguez V 
Published: May 2021

Abstract

INTRODUCTION
The SARS-CoV-2 pandemic has altered daily medical practice in hospitals. A frequently intervened pathology is acute appendicitis, which could be affected by this situation.

MATERIAL AND METHODS
We propose a retrospective observational study on patients involved in our centre. They are divided into two groups, the preCOVID group with 123 patients surgically intervened between 15/03/19 and 31/12/19 and the postCOVID group with 101 patients surgically intervened between 15/03/20 and 31/12/20. We use T Student for quantitative variables and Chi2 for qualitative variables. p &lt; 0.05 was considered statistically significant.

RESULTS
The preCOVID group, 54 males and 64 women. Average age 38.57. Average stay 3.33 days. There were 79 phlegmonous appendicitis, 27 necrotizing, 9 perforated and 8 plastron appendicitis.
The postCOVID group, 57 males and 44 women. Average age 41.12. Average stay 4.27 days. There were 49 phlegmonous appendicitis, 33 necrotizing, 11 perforated and 8 plastron appendicitis.
We observed statistically significant differences from time to intervention and intra-abdominal drainage placement, both being larger in the postCOVID group (p-0.038; p-0.037 respectively). We dońt found statistically significant differences in other variables.

CONCLUSIONS
Patients in the postCOVID group are surgically intervened later, probably motivated by the need to perform a PCR to discount SARS-CoV-2, previously to intervention. More drains are also placed in this group, probably because more acute appendicitis is involved in higher severity phases than in the preCOVID group although there areńt significant differences in this regard.
Phosphate binders in dialysis: better satisfied than sorry
Authors: Cozzolino Mario , Galassi Andrea , Ciceri Paola 
Published: May 2021

Abstract
High serum phosphate levels have been associated with increased morbidity and mortality in dialysis patients. Nephrologists routinely counteract the positive phosphate balance in dialysis patients through nutritional counselling, stronger phosphate removal by dialysis and prescription of phosphate binders. An individualized choice of phosphate binders is a desirable option to improve the poor adherence with these medications’ prescription that has been associated with hyperphosphataemia.
Primary laparoscopic fundoplication in selected patients with gastroesophageal reflux disease
Authors: Fuchs K H , Breithaupt W , Varga G , Babic B , Schulz T , Meining A 
Published: May 2021

Summary

Background
Despite proton pump inhibitors being a powerful therapeutic tool, laparoscopic fundoplication (LF) has proven successful in the treatment of gastroesophageal reflux disease (GERD), through mechanical augmentation of a weak antireflux barrier and the advantages of minimally invasive access. A critical patient selection for LF, based on thorough preoperative assessment, is important for the management of GERD-patients. The purpose of this study is to provide an overview on the management of GERD-patients treated by primary LF in a specialized center and to illustrate the possible outcome after several years.

Methods
Patients were selected after going through diagnostic workup consisting of patient’s history and physical examination, upper gastrointestinal endoscopy, assessment of gastrointestinal Quality of Life Index, screening for somatoform disorders, functional assessment by esophageal manometry, (impedance)-24-hour-pH-monitoring, and selective radiographic studies. The indication for LF was based on EAES-guidelines. Either a floppy and short Nissen fundoplication was performed or a posterior Toupet-hemifundoplication was chosen. A long-term follow-up assessment was attempted after surgery.

Results
In total, n = 1131 patients were evaluated (603 males; 528 females; mean age; 48.3 years; and mean body mass index: 27). The mean duration between onset of symptoms and surgery was 8 years. Nissen: n = 873, Toupet: n = 258; conversion rateerativ: 0.5%; morbidity 4%, mortality: 1 (1131). Mean follow-up (n = 898; 79%): 5.6 years; pre/post-op results: esophagitis: 66%/12.1%; Gastrointestinal Quality of Life Index: median: 92/119; daily proton pump inhibitors-intake after surgery: 8%; and operative revisions 4.3%.

Conclusions
In conclusion, our data show that careful patient selection for laparoscopic fundoplication and well-established technical concepts of mechanical sphincter augmentation can provide satisfying results in the majority of patients with severe GERD.
Rhizosphere shotgun metagenomic analyses fail to show differences between ancestral and modern wheat genotypes grown under low fertilizer inputs
Authors: Quiza Liliana , Tremblay Julien , Greer Charles W , Hemmingsen Sean M , St-Arnaud Marc , Pozniak Curtis J , Yergeau Etienne 
Published: May 2021

ABSTRACT
It is thought that modern wheat genotypes have lost their capacity to associate with soil microbes that would help them acquire nutrients from the soil. To test this hypothesis, ten ancestral and modern wheat genotypes were seeded in a field experiment under low fertilization conditions. The rhizosphere soil was collected, its DNA extracted and submitted to shotgun metagenomic sequencing. In contrast to our hypothesis, there was no significant difference in the global rhizosphere metagenomes of the different genotypes, and this held true when focusing the analyses on specific taxonomic or functional categories of genes. Some genes were significantly more abundant in the rhizosphere of one genotype or another, but they comprised only a small portion of the total genes identified and did not affect the global rhizosphere metagenomes. Our study shows for the first time that the rhizosphere metagenome of wheat is stable across a wide variety of genotypes when growing under nutrient poor conditions.
Quantitative interactions: the disease outcome of Botrytis cinerea across the plant kingdom
Authors: Caseys Celine , Shi Gongjun , Soltis Nicole , Gwinner Raoni , Corwin Jason , Atwell Susanna , Kliebenstein Daniel J 
Published: May 2021

Abstract
Botrytis cinerea is a fungal pathogen that causes necrotic disease on more than a thousand known hosts widely spread across the plant kingdom. How B. cinerea interacts with such extensive host diversity remains largely unknown. To address this question, we generated an infectivity matrix of 98 strains of B. cinerea on 90 genotypes representing eight host plants. This experimental infectivity matrix revealed that the disease outcome is largely explained by variations in either the host resistance or pathogen virulence. However, the specific interactions between host and pathogen account for 16% of the disease outcome. Furthermore, the disease outcomes cluster among genotypes of a species but are independent of the relatedness between hosts. When analyzing the host specificity and virulence of B. cinerea, generalist strains are predominant. In this fungal necrotroph, specialization may happen by a loss in virulence on most hosts rather than an increase of virulence on a specific host. To uncover the genetic architecture of Botrytis host specificity and virulence, a genome-wide association study (GWAS) was performed and revealed up to 1492 genes of interest. The genetic architecture of these traits is widespread across the B. cinerea genome. The complexity of the disease outcome might be explained by hundreds of functionally diverse genes putatively involved in adjusting the infection to diverse hosts.
Rapamycin Activates Mitophagy and Alleviates Cognitive and Synaptic Plasticity Deficits in a Mouse Model of Alzheimer’s Disease
Authors: Wang Hui , Fu Jingxuan , Xu Xinxin , Yang Zhuo , Zhang Tao 
Published: May 2021

Abstract
Alzheimer’s disease (AD) is a chronic neurodegenerative disease, which is characterized by cognitive and synaptic plasticity damage. Rapamycin is an activator of autophagy/mitophagy, which plays an important role in identifying and degrading damaged mitochondria. The aim of this study was to investigate the effect of rapamycin on cognitive and synaptic plasticity defects induced by AD, and further explore if the underlying mechanism was associated with mitophagy. The results show that rapamycin increases Parkin-mediated mitophagy and promotes fusion of mitophagosome and lysosome in the APP/PS1 mouse hippocampus. Rapamycin enhances learning and memory viability, synaptic plasticity, and the expression of synapse-related proteins, impedes cytochrome C-mediated apoptosis, decreases oxidative status, and recovers mitochondrial function in APP/PS1 mice. The data suggest that rapamycin effectively alleviates AD-like behaviors and synaptic plasticity deficits in APP/PS1 mice, which is associated with enhanced mitophagy. Our findings possibly uncover an important function of mitophagy in eliminating damaged mitochondria to attenuate AD-associated pathology.
Lifetime Prevalence of Intimate Partner Violence and Health-Related Outcomes among Transgender Adults Aged 50 and Older
Authors: Hillman Jennifer 
Published: May 2021

Abstract

Background and Objectives
Intimate partner violence (IPV) has been linked with poor health among young transgender adults, and cisgender lesbian, gay, bisexual (LGB), and heterosexual adults aged 50 years and older. The objective was to examine lifetime prevalence of IPV and its association with health, among transgender adults aged 50 and older. Consistent with the Gender Minority Stress Framework, any IPV was hypothesized to be associated with worse health.

Research Design and Methods
Responses from 3,462, transgender adults aged 50 and older from the 2015 U.S. Transgender Survey were assessed for lifetime IPV and type. Logistic regression analyses, adjusted for demographic characteristics, examined the association between any IPV and substance use, and mental and general health measures.

Results
57% of respondents reported any lifetime IPV, including transgender-specific (41%), physical (36%), psychological (29%), severe physical (24%), stalking (12%), and sexual (10%) abuse. Given any, compared to no, experience of IPV, the odds of having a disability (adjusted odds ratio [AOR] = 1.21, confidence interval [CI] = 1.00–1.46) and rating current health more negatively (AOR = 1.17, CI = 1.08–1.26); smoking (AOR = 1.31, CI = 1.08–1.58) and qualifying for screening for serious mental illness (AOR = 1.32, CI = 1.04–1.66) within the last month; and ever using drugs (AOR = 1.42, CI = 1.22–1.65) and attempting suicide (AOR = 1.98, CI = 1.66–2.46) were significantly higher; only binge drinking was unrelated to IPV.

Discussion and Implications
More than half of the respondents experienced IPV, with trans-specific IPV reported most commonly. Lifetime prevalence of any IPV was significantly associated with worse health. Recommendations include health surveillance that recognizes gender identity, and longitudinal study and routine screening of IPV, including trans-specific abuse, among transgender adults aged 50 and older.