Laparoscopic versus open liver resection: a meta‐analysis of long‐term outcome

AbstractBackgroundLaparoscopic liver resection is growing in popularity, but the long‐term outcome of patients undergoing laparoscopic liver resection for malignancy has not been established. This paper is a meta‐analysis and compares the long‐term survival of patients undergoing laparoscopic (LHep) versus open (OHep) liver resection for the treatment of malignant liver tumours.MethodsA PubMed database search identified comparative human studies analysing LHep versus OHep for malignant tumours. Clinical and survival parameters were extracted. The search was last conducted on 18 March 2012.ResultsIn total, 1002 patients in 15 studies were included (446 LHep and 556 OHep). A meta‐analysis of overall survival showed no difference [1‐year: odds ratio (OR) 0.71, 95% confidence interval (CI) 0.42 to 1.20, P = 0.202; 3‐years: OR 0.76, 95% CI 0.56 to 1.03, P = 0.076; 5‐years: OR 0.8, 95% CI 0.59 to 1.10, P = 0.173]. Subset analyses of hepatocellular carcinoma (HCC) and colorectal metastases (CRM) were performed. There was no difference in the 1‐, 3‐, and 5‐year survival for HCC or in the 1‐year survival for CRM, however, a survival advantage was found for CRM at 3 years (LHep 80% versus OHep 67.4%, P = 0.036).ConclusionsLaparoscopic surgery should be considered an acceptable alternative for the treatment of malignant liver tumours

Expanding the diversity of mycobacteriophages: insights into genome architecture and evolution.

Mycobacteriophages are viruses that infect mycobacterial hosts such as Mycobacterium smegmatis and Mycobacterium tuberculosis. All mycobacteriophages characterized to date are dsDNA tailed phages, and have either siphoviral or myoviral morphotypes. However, their genetic diversity is considerable, and although sixty-two genomes have been sequenced and comparatively analyzed, these likely represent only a small portion of the diversity of the mycobacteriophage population at large. Here we report the isolation, sequencing and comparative genomic analysis of 18 new mycobacteriophages isolated from geographically distinct locations within the United States. Although no clear correlation between location and genome type can be discerned, these genomes expand our knowledge of mycobacteriophage diversity and enhance our understanding of the roles of mobile elements in viral evolution. Expansion of the number of mycobacteriophages grouped within Cluster A provides insights into the basis of immune specificity in these temperate phages, and we also describe a novel example of apparent immunity theft. The isolation and genomic analysis of bacteriophages by freshman college students provides an example of an authentic research experience for novice scientists

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Mastery Skill Assessment in Hepato-Pancreato-Biliary Surgical Ultrasound

Background: A formative Hepato-Pancreato-Biliary (HPB) ultrasound (US) skills practicum is offered annually to HPB fellows in Americas Hepato-Pancreato-Biliary Association-Fellowship Council (AHPBA-FC) accredited programs, using assessment tools for open (IOUS) and laparoscopic (LAPUS) US. The aim of this work is to collect validity evidence for the IOUS and LAPUS tools, while establishing and applying Mastery standards and to a sample of graduating fellows. Methods: Faculty Survey (content; consequential validity): Expert AHPBA faculty were surveyed to evaluate the importance of each IOUS and LAPUS skill and to set Mastery Angoff probabilities. Item-level Mastery Angoff cut scores were determined as the mean rating across all judges. The overall Mastery Angoff cut score was determined as the mean cut score across all items. Mastery Angoff cut scores were converted to the 5-point entrustment scale (i.e., cut score*5). Fellow performance (response process; consequential validity): Fellow performances were evaluated using the IOUS and LAPUS tools (entrustment rating) during two annual US skills practicums, and fellow experience was collected. Mastery Angoff standards were applied. This study met criteria for exemption by the University of Illinois-Chicago Institutional Review Board (2019-0265). Results: Data from 11 faculty questionnaires were included. The mean cut scores across all items (Mastery Angoff) was 92% (equivalent entrustment 4.6) and 91% (entrustment 4.5) for IOUS and LAPUS, respectively. The mean global cut scores (Mastery Global Angoff) were 96% (SD 6.4%) and 89% (13.8%) for IOUS and LAPUS, respectively. 78.5% (29/37) fellows agreed to have their de-identified data evaluated. The mean fellow performance entrustment scores (across all skills) were 4.1 (SD 0.6, range 2.6-4.9) and 3.9 (SD 0.7, range 2.7-5), while the mean global fellow performances were 3.6 (SD 0.8, range 2-5) 3.5 (SD 1.0, range 2-5) for IOUS and LAPUS, respectively. Conclusion: AHPBA-FC HPB fellows prior to graduation are not meeting Mastery Standards for HPB US performance determined by a panel of expert faculty. A change in educational policy or curriculum may be needed to improve fellow performance

Expanding the diversity of mycobacteriophages: insights into genome architecture and evolution.

Mycobacteriophages are viruses that infect mycobacterial hosts such as Mycobacterium smegmatis and Mycobacterium tuberculosis. All mycobacteriophages characterized to date are dsDNA tailed phages, and have either siphoviral or myoviral morphotypes. However, their genetic diversity is considerable, and although sixty-two genomes have been sequenced and comparatively analyzed, these likely represent only a small portion of the diversity of the mycobacteriophage population at large. Here we report the isolation, sequencing and comparative genomic analysis of 18 new mycobacteriophages isolated from geographically distinct locations within the United States. Although no clear correlation between location and genome type can be discerned, these genomes expand our knowledge of mycobacteriophage diversity and enhance our understanding of the roles of mobile elements in viral evolution. Expansion of the number of mycobacteriophages grouped within Cluster A provides insights into the basis of immune specificity in these temperate phages, and we also describe a novel example of apparent immunity theft. The isolation and genomic analysis of bacteriophages by freshman college students provides an example of an authentic research experience for novice scientists