Consensus statement on natural orifice transluminal endoscopic surgery and single-incision laparoscopic surgery: heralding a new era in urology?

[Excerpt] For decades, urologists have implemented technologies that provide effective treatment while limiting morbidity. In many instances, this has been achieved by operating via natural body openings (eg, cystoscopy, transurethral resection, and ureteroscopy) [1,2]. Urologists have also pioneered novel techniques to address clinical situations where access through natural body openings was impossible, such as percutaneous stone surgery, laparoscopy, and robotics [3–5].[...

An empirical analysis of the determinants of mobile instant messaging appropriation in university learning

Published ArticleResearch on technology adoption often profiles device usability (such as perceived usefulness) and user dispositions (such as perceived ease of use) as the prime determinants of effective technology adoption. Since any process of technology adoption cannot be conceived out of its situated contexts, this paper argues that any pre-occupation with technology acceptance from the perspective of device usability and user dispositions potentially negates enabling contexts that make successful adoption a reality. Contributing to contemporary debates on technology adoption, this study presents flexible mobile learning contexts comprising cost (device cost and communication cost), device capabilities (portability, collaborative capabilities), and learner traits (learner control) as antecedents that enable the sustainable uptake of emerging technologies. To explore the acceptance and capacity of mobile instant messaging systems to improve student performance, the study draws on these antecedents, develops a factor model and empirically tests it on tertiary students at a South African University of Technology. The study involved 223 national diploma and bachelor’s degree students and employed partial least squares for statistical analysis. Overall, the proposed model displayed a good fit with the data and rendered satisfactory explanatory power for students’ acceptance of mobile learning. Findings suggest that device portability, communication cost, collaborative capabilities of device and learner control are the main drivers of flexible learning in mobile environments. Flexible learning context facilitated by learner control was found to have a positive influence on attitude towards mobile learning and exhibited the highest path coefficient of the overall model. The study implication is that educators need to create varied learning opportunities that leverage learner control of learning in mobile learning systems to enhance flexible mobile learning. The study also confirmed the statistical significance of the original Technology Acceptance Model constructs

Conserved Genes Act as Modifiers of Invertebrate SMN Loss of Function Defects

Spinal Muscular Atrophy (SMA) is caused by diminished function of the Survival of Motor Neuron (SMN) protein, but the molecular pathways critical for SMA pathology remain elusive. We have used genetic approaches in invertebrate models to identify conserved SMN loss of function modifier genes. Drosophila melanogaster and Caenorhabditis elegans each have a single gene encoding a protein orthologous to human SMN; diminished function of these invertebrate genes causes lethality and neuromuscular defects. To find genes that modulate SMN function defects across species, two approaches were used. First, a genome-wide RNAi screen for C. elegans SMN modifier genes was undertaken, yielding four genes. Second, we tested the conservation of modifier gene function across species; genes identified in one invertebrate model were tested for function in the other invertebrate model. Drosophila orthologs of two genes, which were identified originally in C. elegans, modified Drosophila SMN loss of function defects. C. elegans orthologs of twelve genes, which were originally identified in a previous Drosophila screen, modified C. elegans SMN loss of function defects. Bioinformatic analysis of the conserved, cross-species, modifier genes suggests that conserved cellular pathways, specifically endocytosis and mRNA regulation, act as critical genetic modifiers of SMN loss of function defects across species

Efficacy of Endoscopic Submucosal Dissection for Superficial Gastric Neoplasia in a Large Cohort in North America

Background & Aims Endoscopic submucosal dissection (ESD) is a widely accepted treatment option for superficial gastric neoplasia in Asia, but there are few data on outcomes of gastric ESD from North America. We aimed to evaluate the safety and efficacy of gastric ESD in North America. Methods We analyzed data from 347 patients who underwent gastric ESD at 25 centers, from 2010 through 2019. We collected data on patient demographics, lesion characteristics, procedure details and related adverse events, treatment outcomes, local recurrence, and vital status at the last follow up. For the 277 patients with available follow-up data, the median interval between initial ESD and last clinical or endoscopic evaluation was 364 days. The primary endpoint was the rate of en bloc and R0 resection. Secondary outcomes included curative resection, rates of adverse events and recurrence, and gastric cancer-related death. Results Ninety patients (26%) had low-grade adenomas or dysplasia, 82 patients (24%) had high-grade dysplasia, 139 patients (40%) had early gastric cancer, and 36 patients (10%) had neuroendocrine tumors. Proportions of en bloc and R0 resection for all lesions were 92%/82%, for early gastric cancers were 94%/75%, for adenomas and low-grade dysplasia were 93%/ 92%, for high-grade dysplasia were 89%/ 87%, and for neuroendocrine tumors were 92%/75%. Intraprocedural perforation occurred in 6.6% of patients; 82% of these were treated successfully with endoscopic therapy. Delayed bleeding occurred in 2.6% of patients. No delayed perforation or procedure-related deaths were observed. There were local recurrences in 3.9% of cases; all occurred after non-curative ESD resection. Metachronous lesions were identified in 14 patients (6.9%). One of 277 patients with clinical follow up died of metachronous gastric cancer that occurred 2.5 years after the initial ESD. Conclusions ESD is a highly effective treatment for superficial gastric neoplasia and should be considered as a viable option for patients in North America. The risk of local recurrence is low and occurs exclusively after non-curative resection. Careful endoscopic surveillance is necessary to identify and treat metachronous lesions

CaribVET: A Model for Surveillance of Zoonotic Diseases

International audienceThe Caribbean region is considered to be at risk for zoonotic diseases because of widespread backyard breeding system, diverse disease surveillance systems, legal or illegal human and animal movements. Several zoonosis are reported including Influenza, West Nile, Rabies, Leptospirosis