The NOTES Approach to Management of Urinary Bladder Injury

This blinded feasibility study shows that urinary bladder injury occurring during NOTES can be successfully managed via a NOTES approach using currently available endoscopic accessories

Multicenter Experience with Nonischemic Multiport Laparoscopic and Laparoendoscopic Single-Site Partial Nephrectomy Utilizing Bipolar Radiofrequency Ablation Coagulator

Objective. To investigate feasibility of multiport and laparoendoscopic single-site (LESS) nonischemic laparoscopic partial nephrectomy (NI-LPN) utilizing bipolar radiofrequency coagulator. Methods. Multicenter retrospective review of 60 patients (46 multiport/14 LESS) undergoing NI-LPN between 4/2006 and 9/2009. Multiport and LESS NI-LPN utilized Habib 4X bipolar radiofrequency coagulator to form a hemostatic zone followed by nonischemic tumor excision and renorrhaphy. Demographics, tumor/perioperative characteristics, and outcomes were analyzed. Results. 59/60 (98.3%) successfully underwent NI-LPN. Mean tumor size was 2.35 cm. Mean operative time was 160.0 minutes. Mean estimated blood loss was 131.4 mL. Preoperative/postoperative creatinine (mg/dL) was 1.02/1.07 (P = .471). All had negative margins. 12 (20%) patients developed complications. 3 (5%) developed urine leaks. No differences between multiport and LESS-PN were noted as regards demographics, tumor size, outcomes, and complications. Conclusion. Initial experience demonstrates that nonischemic multiport and LESS-PN is safe and efficacious, with excellent short-term preservation of renal function. Long-term data are needed to confirm oncological efficacy

Resistance and resilience of social–ecological systems to recurrent typhoon disturbance on a subtropical island: Taiwan

Tropical cyclones (TCs) have major effects on ecological and social systems. However, studies integrating the effects of TCs on both social and ecological systems are rare, especially in the northwest Pacific, where the frequency of TCs (locally named typhoons) is the highest in the world. We synthesized studies of effects of recurrent typhoons on social and ecological systems in Taiwan over the last several decades. Many responses to TCs are comparable between social and ecological systems. High forest ecosystem resistance, evident from tree mortality below 2% even following multiple strong typhoons, is comparable with resistance of social systems, including the only 4% destruction of river embankments following a typhoon that brought nearly 3000 mm rainfall in three days. High resilience as reflected by quick returns of leaf area index, mostly in one year, and streamwater chemistry, one to several weeks to pre‐typhoon levels of ecosystems, are comparable to quick repair of the power grid within one to several days and returns of vegetable price within several weeks to pre‐typhoon levels of the social systems. Landslides associated with intense typhoons have buried mountain villages and transported large quantities of woody debris to the coast, affecting the coastal plains and reefs, illustrating a ridge‐to‐reef link between ecological and societal systems. Metrics of both social and ecological function showed large fluctuations in response to typhoons but quickly returned to pre‐disturbance levels, except when multiple intense typhoons occurred within a single season. Our synthesis illustrates that the social–ecological systems in Taiwan are highly dynamic and responsive to frequent typhoon disturbance, with extraordinarily high resistance and resilience. For ecosystems, the efficient responsiveness results from the selective force of TCs on ecosystem structure and processes. For social systems, it is the result of the effects of TCs on planning and decision making by individuals (e.g., farmers), management sectors, and ultimately the government. In regions with frequent TCs, the social–ecological systems are inevitably highly dynamic and rapid responses are fundamental to system resistance and resilience which in turn is key to maintaining structure and function of the social–ecological systems

Adrenocorticotrophic hormone-stimulated cortisol release by the head kidney inter-renal tissue from sea bream (Sparus aurata) fed with linseed oil and soyabean oil

The mode of action of highly unsaturated fatty acids (HUFA) in regulating gilthead sea bream (Sparus aurata) head kidney (HK) cortisol production was studied through in vitro trials using a dynamic superfusion system. Fish were previously fed with different diets containing several inclusion levels of linseed oil (LO) or soyabean oil (SO) for 26 weeks. Five diets were tested; anchovy oil was the only lipid source for the control diet (fish oil, FO) and two different substitution levels (70 and 100 %) were tested using either LO or SO (70LO, 70SO, 100LO and 100SO). Fatty acid compositions of the HK reflected the dietary input, thus EPA, DHA, arachidonic acid and n-3 HUFA were significantly (P,0·05) reduced in fish fed vegetable oils compared with fish fed the FO diet. Feeding 70 or 100% LO increased significantly (P,0·05) cortisol release in HK after stimulation with adrenocorticotrophic hormone (ACTH), while feeding SO had no effect on this response. Cortisol stimulation factor (SF) was increased in fish fed the 70LO and 100LO diets compared with fish fed the control diet. Moreover, eicosanoid inhibition by incubating the HK tissue with indomethacin (INDO) as a cyclo-oxygenase (COX) inhibitor, or nordihydroguaiaretic acid (NDGA) as a lipoxygenase (LOX) inhibitor, significantly reduced (P,0·05) the cortisol release after ACTH stimulation in the 70LO and 100LO diets. Cortisol SF was reduced in the FO, 70LO and 100LO diets when incubating the HK with INDO or NDGA, while it was increased in the 70SO diet. The present results indicate that changing the fatty acid profile of gilthead sea bream HK by including LO and/or SO in the fish diet affected the in vitro cortisol release, and this effect is partly mediated by COX and/or LOX metabolites

Multiple stressor effects on marine infauna: responses of estuarine taxa and functional traits to sedimentation, nutrient and metal loading

Sedimentation, nutrients and metal loading to coastal environments are increasing, associated with urbanization and global warming, hence there is a growing need to predict ecological responses to such change. Using a regression technique we predicted how maximum abundance of 20 macrobenthic taxa and 22 functional traits separately and interactively responded to these key stressors. The abundance of most taxa declined in response to sedimentation and metal loading while a unimodal response was often associated with nutrient loading. Optimum abundances for both taxa and traits occurred at relatively low stressor levels, highlighting the vulnerability of estuaries to increasing stressor loads. Individual taxa were more susceptible to stress than traits, suggesting that functional traits may be less sensitive for detecting changes in ecosystem health. Multiplicative effects were more common than additive interactions. The observed sensitivity of most taxa to increasing sedimentation and metal loading and the documented interaction effects between multiple stressors have important implications for understanding and managing the ecological consequences of eutrophication, sedimentation and contaminants on coastal ecosystems

Stress related epigenetic changes may explain opportunistic success in biological invasions in Antipode mussels

Different environmental factors could induce epigenetic changes, which are likely involved in the biological invasion process. Some of these factors are driven by humans as, for example, the pollution and deliberate or accidental introductions and others are due to natural conditions such as salinity. In this study, we have analysed the relationship between different stress factors: time in the new location, pollution and salinity with the methylation changes that could be involved in the invasive species tolerance to new environments. For this purpose, we have analysed two different mussels’ species, reciprocally introduced in antipode areas: the Mediterranean blue mussel Mytilus galloprovincialis and the New Zealand pygmy mussel Xenostrobus securis, widely recognized invaders outside their native distribution ranges. The demetylathion was higher in more stressed population, supporting the idea of epigenetic is involved in plasticity process. These results can open a new management protocols, using the epigenetic signals as potential pollution monitoring tool. We could use these epigenetic marks to recognise the invasive status in a population and determine potential biopollutants

Maternal anthropometry for prediction of pregnancy outcomes: Memorandum from a USAID/WHO/PAHO/MotherCare meeting

The meeting discussed two main areas concerning maternal anthropometry in developing countries: (1) how various anthropometric indicators can be best utilized for assessing and monitoring the nutritional status of women at different times in their reproductive lives, and (2) the predictive value of various anthropometric indicators for identifying benefit or risk for maternal and perinatal/neonatal health and nutritional outcomes of pregnancy. The indicators discussed were prepregnancy weight, height, weight gain in pregnancy, arm circumference, weight-for-height and body mass index (weight (kg)/height (m)2). Some 50 experts reached consensus on the tools for assessing maternal nutritional status for widespread field application in developing countries, and on priority research needs. This Memorandum summarizes the general recommendations which have important and immediate field applications, as well as priority research issues related to specific indicators

Modulation of the expression of components of the stress response by dietary arachidonic acid in European sea bass (Dicentrarchus labrax) larvae

This study reports for the first time in European sea bass, Dicentrarchus labrax (L.), larvae, the effect of different levels of dietary arachidonic acid (ARA; 20:4n-6) on the expression of genes related to the fish stress response. Copies of mRNA from genes related to steroidogenesis (StAR (steroidogenic acute regulatory protein), c-Fos, and CYP11β (11β- hydroxylase gene)), glucocorticoid receptor complex (GR (glucorticoid receptor) and HSP (heat shock proteins) 70 and 90) and antioxidative stress (catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPX)) were quantified. Eighteen day-old larvae were fed for 14 days with three experimental diets with increasing levels of ARA (0.3, 0.6 and 1.2% d.w.) and similar levels of docosahexaenoic (DHA; 22:6n-3) and eicosapentaenoic (EPA; 20:5n-3) acids (5 and 3%, respectively). The quantification of stress-related genes transcripts was conducted by One-Step TaqMan real time RT-PCR with the standard curve method (absolute quantification). Increase dietary levels of ARA induced a significantly (p<0.05) down-regulation of genes related to cortisol synthesis, such as StAR and CYP11β and up-regulated genes related to glucocorticoid receptor complex, such as HSP70 and GR. No effects were observed on antioxidant enzymes gene expression. These results revealed the regulatory role of dietary ARA on the expression of stress-related genes in European sea bass larvae