Early experience with the ARTISENTIAL® articulated instruments in laparoscopic low anterior resection with TME

Background: The notion of articulation in surgery has been largely synonymous with robotics. The ARTISENTIAL® instruments aim at bringing advanced articulation to laparoscopy to overcome challenges in narrow anatomical spaces. In this paper, we present first single-center results of a series of low anterior resections, performed with ARTISENTIAL®. Methods: Between September 2020 and August 2021, at the Department of Surgery, St. Marienkrankenhaus Siegen, Siegen, Germany, patients with cancer of the mid- and low rectum were prospectively enrolled in a pilot feasibility study to evaluate the ARTISENTIAL® articulated instruments in performing a laparoscopic low anterior resection. Perioperative and short-term postoperative data were analyzed. Results: Seventeen patients (10 males/7 females) were enrolled in this study. The patients had a median age of 66 years (range 47–80 years) and a median body mass index of 28 kg/m2 (range 23–33 kg/m2). The median time to rectal transection was 155 min (range 118–280 min) and the median total operative time was 276 min (range 192–458 min). The median estimated blood loss was 30 ml (range 5–70 ml) and there were no conversions to laparotomy. The median number of harvested lymph nodes was 15 (range 12–28). Total mesorectal excision (TME) quality was ‘good’ in all patients with no cases of circumferential resection margin involvement (R0 = 100%). The median length of stay was 9 days (range 7–14 days). There were no anastomotic leaks and the overall complication rate was 17.6%. There was one unrelated readmission with no mortality. Conclusions: Low anterior resection with ARTISENTIAL® is feasible and safe. All patients had a successful TME procedure with a good oncological outcome. We will now seek to evaluate the benefits of ARTISENTIAL® in comparison with standard laparoscopic instruments through a larger study

Conflicts Among Hawaii’s Muslims

One often reads about the larger Muslim communities in California, Michigan, and New York, but rarely has the opportunity to know about the Muslim community in Hawaii. Despite Hawaii’s rich cultural mix and accommodation of Asian and Pacific ethnicities, Hawaiin Muslims do not appear to have successfully built a harmonious community within the larger Hawaiian society

Ambientalizar el currículum: una propuesta para mejorar la calidad de vida

La ambientalización del currículum consiste en introducir contenidos ambientales en el currículo de las materias que intervienen en la formación del alumnado, entendiendo como contenidos los conceptos, procedimientos y actitudes que todo/a profesional debe adquirir durante su formación. La propuesta presentada tiene por objetivos despertar el interés por los temas ambientales en los alumnos y la comunidad escolar, para asumir un compromiso e implicarse en la tarea del cuidado de los ecosistemas naturales y humanizados. Se pretende rescatar la importancia del trabajo comunitario bien organizado para enfrentar los problemas ambientales e investigar sobre el diseño, desarrollo y evaluación de actividades de educación ambiental. El trabajo se abordará desde tres ámbitos distintos: Desde la formación de los futuros docentes de EPB N°9 (Educación Primaria Básica) que se encuentran desarrollando sus prácticas de campo; Desde la práctica escolar cotidiana; Desde la comunicación vecinal. La metodología a utilizar será la investigación-acción, para favorecer la reflexión crítica de la práctica educativa.Trabajos del área Ciencias NaturalesDepartamento de Ciencias Exactas y Naturale

Effects of Uniform and Differential Rotation on Stellar Pulsations

We have investigated the effects of uniform rotation and a specific model for differential rotation on the pulsation frequencies of 10 \Msun\ stellar models. Uniform rotation decreases the frequencies for all modes. Differential rotation does not appear to have a significant effect on the frequencies, except for the most extreme differentially rotating models. In all cases, the large and small separations show the effects of rotation at lower velocities than do the individual frequencies. Unfortunately, to a certain extent, differential rotation mimics the effects o f more rapid rotation, and only the presence of some specific observed frequencies with well identified modes will be able to uniquely constrain the internal rotation of pulsating stars.Comment: 33 pages, 16 figures. Accepted for publication in Ap

Circumcision and penile human papillomavirus prevalence in human immunodeficiency virus-infected men: heterosexual and men who have sex with men

AbstractMale circumcision is associated with a lower risk of penile human papillomavirus (HPV) infection in human immunodeficiency virus (HIV) uninfected men. Few studies have evaluated the role of male circumcision in penile HPV infection in HIV-infected men. The aim of this cross-sectional study was to examine the association between male circumcision and the prevalence of penile HPV infection among HIV-infected men—both men who have sex with men (MSM) and heterosexual men. Samples from 706 consecutive men included in the CARH-MEN cohort (overall 24% circumcised: 26% of MSM, 18% of heterosexual men) were examined by Multiplex-PCR. In the overall group (all HIV-infected men included), the prevalence of any penile HPV infection was 22% in circumcised men and 27% in uncircumcised men (OR = 1.0, 95% CI 0.6–1.6, adjusted analysis). In the circumcised group the overall prevalence of HPV infection was 22% in MSM and 24% in the heterosexual men, whereas in the uncircumcised group the prevalence was 26% and 28%, respectively. The prevalence of high-risk HPV types tended to be lower in the circumcised MSM (14% vs 21%, OR = 0.6, 95% CI 0.3–1.1, p 0.088), but it was similar in the heterosexual men (18% in circumcised vs 20% in uncircumcised). These results suggest that male circumcision may be associated with a lower prevalence of oncogenic high-risk penile HPV infection in HIV-infected MSM

Analysis of ORF5 and Full-Length Genome Sequences of Porcine Reproductive and Respiratory Syndrome Virus Isolates of Genotypes 1 and 2 Retrieved Worldwide Provides Evidence that Recombination Is a Common Phenomenon and May Produce Mosaic Isolates

Recombination is currently recognized as a factor for high genetic diversity, but the frequency of such recombination events and the genome segments involved are not well known. In the present study, we initially focused on the detection of recombinant porcine reproductive and respiratory syndrome virus (PRRSV) isolates by examining previously published data sets of ORF5 sequences (genotypes 1 and 2) obtained worldwide. We then examined full-length genome sequences in order to determine potential recombination breakpoints along the viral genome. For ORF5, 11 sets of genotype 1 sequences from different geographical areas, including 2 Asian, 1 American, and 7 European regions, and three sets of genotype 2, including sets from China, Mexico, and the United States, were analyzed separately. Potential recombination breakpoints were detected in 10/11 genotype 1 sets, including 9 cases in which the clustering of at least one isolate was different before and after the breakpoints. In genotype 2, potential breakpoints and different tree clustering of at least one strain before and after the breakpoint were observed in 2 out of 3 sets. The results indicated that most of the ORF5 data sets contained at least one recombinant sequence. When the full-length genome sequences were examined, both genotype 1 and 2 sets presented breakpoints (10 and 9, respectively), resulting in significantly different topologies before and after the breakpoints. Mosaic genomes were detected in genotype 1 sequences. These results may have significant implications for the understanding of the molecular epidemiology of PRRSV. IMPORTANCE PRRSV is one of the most important viruses affecting swine production worldwide, causing big economic losses and sanitary problems. One of the key questions on PRRSV arises from its genetic diversity, which is thought to have a direct impact on immunobiology, epidemiology, diagnosis, and vaccine efficacy. One of the causes of this genetic diversity is recombination among strains. This study provides evidence that recombinant PRRSV isolates are common in most of the countries with significant swine production, especially PRRSV genotype 1. This observation has implications in the proper characterization of PRRSV strains, in the future development of phylogenetic studies, and in the development of new PRRSV control strategies. Moreover, the present paper emphasizes the need for a deeper understanding of the mechanisms and circumstances involved in the generation of genetic diversity of PRRSV

Notes on artificial substrates for black fly (diptera: simuliidae) larvae and microsporidian infection in Central Amazonia, Brazil.

Comparou-se três tipos de substratos (filamento plástico branco; ladrilho, blocos de ardósia cinza; e fita plástica, cor amarela) na captura de larvas de simulídeo em 5 períodos de exposição (1, 5, 7, 10 e 14 dias). O estudo foi realizado a 51 km a SE de Manaus, AM, onde foram coletadas 3 espécies: Simulium quadrifidum Lutz (81%), Simulium sp. (17,3%) e Simulium perflavum Roubaud (1,7%). Através da análise de variância dos parâmetros estudados verificou-se diferenças significativas entre os substratos utilizados (P < 0,001), mas não entre os períodos de colonização. A fita plástica foi o substrato mais eficiente para capturar imaturos de simulideos (P < 0,05), não havendo diferença significativa entre os substratos ladrilho e filamento plástico. Durante o período de estudo foi observado infecção por microsporídio (Amblyospora bracteata (Strickland)) apenas em S. quadrifidum