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1.
Sci Adv ; 10(41): eado6262, 2024 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-39392889

RESUMEN

Phanerozoic orogenic gold mineralization at craton margins is related to the metasomatism of the lithospheric mantle by crustal material. Slab subduction transfers Au from the crust to the metasomatized mantle and oxidizes the latter to facilitate the mobilization of Au into mantle melts. The role of volatiles in the mobilization of Au in the mantle is unclear because of the absence of direct geochemical evidence relating the mantle source of Au to Au mineralization in the overlying crust. This study uses lithium isotopes from a large suite of lamprophyres to characterize the mantle beneath the eastern North China Craton, which hosts giant Mesozoic gold deposits. Our results indicate a strong genetic link between carbonate metasomatism in the mantle and Au mineralization in the overlying crust. Although pre-enrichment of Au in the mantle is critical for forming giant Au provinces, the oxidation of the lithospheric mantle controls the mobilization of Au.

2.
J Surg Educ ; 81(12): 103274, 2024 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-39378674

RESUMEN

OBJECTIVE: There is concern that current surgical residents are suboptimally prepared for autonomous practice. This qualitative study aimed to clarify perceptions of competency, autonomy and surgical training goals by Canadian cardiac surgery programs and trainees. DESIGN: This was a qualitative study using semistructured interviews. These were audio recorded and transcribed verbatim. We used thematic analysis and content analysis to deductively analyze interview transcripts. From this, we identified major themes describing competency, autonomy, and goals of surgical training. SETTING: All interviews were conducted online over Zoom. PARTICIPANTS: We interviewed 16 individuals (7 trainees and 9 program directors) from 10 Canadian cardiac surgery training programs. RESULTS: Both trainees and staff agreed that the goal of surgical residency is to produce competent, not autonomous, surgeons. When defining competency, both faculty and trainees identified the importance of technical skills and nontechnical skills, such as surgical decision-making. Both groups believed autonomy and competency to be different, wherein autonomy assumes competency and is distinguished by the ability to make decisions independently. Importantly, 81% (n=13) believed that nontechnical skills were more important for independent practice than technical skills. Only 57% (n=4) of trainees and 33% (n=3) of staff surgeons felt that the current RCPSC competencies were reasonable to achieve during residency training. CONCLUSION: We have identified several important discrepancies in the perceptions of competency, autonomy, and surgical training goals. The RCPSC (Royal College of Physicians and Surgeons of Canada) stated goal of producing trainees who are ready for independent practice is discordant with the perspective of Canadian cardiac surgery programs. Many staff and trainees do not feel that the currently espoused competencies are feasible to achieve by graduation. The results of our study will allow us to identify the barriers during training to produce trainees ready for independent practice.

3.
Behav Processes ; 222: 105099, 2024 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-39265896

RESUMEN

Leadership is a risky behaviour that can impact individuals and groups. Leaders, i.e. individuals who perform or initiate a task while other individuals in the group follow, have been studied in different contexts, but there is still a lack of understanding on the role of individual characteristics that may predispose them to become leaders, such as dominance and personality. In particular, the characteristics of leaders in domestic animal populations has been poorly examined. We studied leadership within 32 groups of young pigs (Sus scrofa domesticus, n = 366 individuals). Leadership was assessed during a group-based fear test (Human Approach Test) which was repeated three times. The first individual per group to touch the person was identified as leader. We assessed repeatability of leadership and characteristics of leaders as compared to followers. Leadership was marginally repeatable, with 6 out of 26 groups having a consistent single leader across all tests. Females had odds 4.13 times greater than males of being a leader, while there was no effect of body weight (a proxy of dominance) or coping style on leadership. The results indicate a similarity with wild populations, in which females lead the herd even though the males, which are superior in body weight, are often dominant.

4.
PLoS One ; 19(9): e0311023, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39325786

RESUMEN

This paper examines the role of temporality in the negotiation of unplanned adaptive tasks that were part of the health system response to the Covid-19 pandemic in Colombia. While research has been carried out on the temporal aspects of emergency preparedness, we argue that there is an empirical gap concerning how health care organizations responded with temporal urgency to Covid-19. The dataset (118 interviews) from which a subset of interviews were analysed for this paper was collected during the first wave of the pandemic in Colombia in 2020. Interviewees included representatives of national and regional governments, public hospitals and private clinic managers, clinicians, including physicians and nurses, laboratory directors, and academics. Narratives of two tasks are presented: reconfiguring clinical laboratories to expand the testing capacity for Covid-19 and increasing intensive care unit capacity for patients hospitalized with Covid-19. Through thematic analysis of the navigation of these tasks, the concept of "temporal shifts", which signifies how organizations use time as a resource (analogous experiences, future projections) to negotiate unplanned service changes, is developed. This study highlights how powerful stakeholders deploy past and future projections to influence others´ perceptions in the negotiation of temporal shifts: a type of change that differs from the incremental and planned types described in previous organizational literature on temporality. This shift was initiated by rapid task delegation via organizational hierarchy, but accomplished through pressured, improvised actions at the operational level. The policy and practice implications we suggest relate to addressing social and organizational effects, including consequences for stakeholder engagement and staff wellbeing, generated by organizational leaders making decisions under "time stress".


Asunto(s)
COVID-19 , Atención a la Salud , COVID-19/epidemiología , Humanos , Colombia/epidemiología , Pandemias , SARS-CoV-2 , Unidades de Cuidados Intensivos
5.
J Environ Manage ; 369: 122155, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39216356

RESUMEN

Since the 1980s, fish farming (aquaculture) has been an important contributor to Scotland's economy, but there are concerns that nutrient-rich food waste and excreta from these farms are causing eutrophication. Water quality monitoring preceding the arrival and subsequent expansion of the industry is limited. Therefore, to better understand the impacts of in-lake fish farms on the quality of freshwater ecosystems, we examined the diatom records in sediment cores from seven freshwater lochs in Scotland over a timescale of c.100-200 years, spanning the period before and after installation of the fish cages at these sites. At three lochs (A, C, E) we observed marked diatom assemblage shifts indicative of eutrophication, coincident with arrival of the fish farms, at two lochs (B, G) there was evidence of enrichment over a longer timescale although with some further enrichment occurring with the advent of the fish farms, and at the other two lochs (D, F), diatom shifts were subtle and showed no sign of eutrophication. Thus, while marked ecological shifts are shown to occur with the arrival of fish farms in some sites, this is not always the case. The natural background conditions, the scale of operations, the siting of the fish cages in relation to location of inflows and outflows, the role of flushing rate and additional sources of nutrients are discussed as potential factors for the variable impacts observed across the seven lochs. Such factors should be considered when planning future installation and expansion of fish farms to ensure sustainable development of these resources. Our study provides an understanding of baseline conditions and long-term water quality trajectories in freshwater lakes with fish farms and demonstrates the value of paleolimnology in supporting management decisions with respect to fisheries.


Asunto(s)
Eutrofización , Agua Dulce , Calidad del Agua , Animales , Escocia , Peces , Acuicultura , Ecosistema , Diatomeas , Monitoreo del Ambiente
8.
Surg Endosc ; 38(8): 4152-4159, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38902404

RESUMEN

BACKGROUND: Anastomotic leak after esophagectomy is a major contributor to surgery-related morbidity and mortality. The purpose of this systematic review was to evaluate if positive-smoking status is associated with the incidence of this complication. METHODS: A systematic search of MEDLINE, EMBASE, Scopus, Web of Science and Cochrane Library was performed on April 4th, 2023. Inclusion criteria comprised human participants undergoing esophagectomy, age ≥ 18, n ≥ 5, and identification of smoking status. The primary outcome was incidence of anastomotic leak. Sub-group analysis by ex- or current smoking status was performed. Meta-analysis was performed with RevMan 5.4.1 using a Mantel-Haenszel random-effects model. Publication bias was evaluated visually with funnel plots and through the Egger test. RESULTS: A total of 220 abstracts were screened, of which 69 full-text studies were assessed for eligibility, with 13 studies selected for final inclusion. This included 16,103 patients, of which 4433 were ex- or current smokers, and 9141 were never smokers. Meta-analysis revealed an increased odds of anastomotic leak in patients with a positive-smoking status (current or ex-smokers) compared to never smokers (OR 1.44, 95% CI 1.18-1.76, I2 = 44%, p < 0.001. Meta-analysis of six studies comparing active smokers alone to never smokers identified a significant increased odds of anastomotic leak (OR 1.80, 95% CI 1.25-2.59, p = 0.002, I2 = 0%). Meta-analysis of five studies comparing ex-smokers to never smokers identified a significant increased odds of anastomotic leak (OR 1.36, 95% CI 1.02-1.82, p = 0.04, I2 = 0%). The odds of anastomotic leak decreased among ex-smokers compared to active smokers. CONCLUSION: The findings of this systematic review and meta-analysis support the association between positive-smoking status and the risk of anastomotic leak after esophagectomy. Results further emphasize the importance of preoperative smoking cessation to reduce post-operative morbidity.


Asunto(s)
Fuga Anastomótica , Esofagectomía , Fumar , Fuga Anastomótica/etiología , Fuga Anastomótica/epidemiología , Humanos , Esofagectomía/efectos adversos , Fumar/efectos adversos , Fumar/epidemiología , Neoplasias Esofágicas/cirugía , Factores de Riesgo , Incidencia
9.
Surg Endosc ; 38(6): 2995-3003, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38649492

RESUMEN

BACKGROUND: Studies have evaluated the efficacy of endoscopic incisional therapy (EIT) for benign anastomotic strictures. We performed a systematic review and meta-analysis to evaluate stricture recurrence after EIT following esophagectomy or gastrectomy. METHODS: A systematic search of databases was performed up to April 2nd, 2023, after selection of key search terms with the research team. Inclusion criteria included human participants undergoing EIT for a benign anastomotic stricture after esophagectomy or gastrectomy, age ≥ 18, and n ≥ 5. Our primary outcome was the incidence of stricture recurrence among patients treated with EIT compared to dilation. Our secondary outcome was the stricture-free duration after EIT and rate of adverse events. Meta-analysis was performed with RevMan 5.4.1 using a Mantel-Haenszel random-effects model. Publication bias was evaluated with funnel plots and the Egger test. RESULTS: A total of 2550 unique preliminary studies underwent screening of abstracts and titles. This led to 33 studies which underwent full-text review and five studies met the inclusion criteria. Meta-analysis revealed reduced odds of overall stricture recurrence (OR 0.35, 95% CI 0.13-0.92, p = 0.03; I2 = 71%) and reduced odds of stricture recurrence among naïve strictures (OR 0.32, 95% CI 0.17-0.59, p = 0.0003; I2 = 0%) for patients undergoing EIT compared to dilation. There was no significant difference in the odds of stricture recurrence among recurrent strictures (OR 0.63, 95% CI 0.12-3.28, p = 0.58; I2 = 81%). Meta-analysis revealed a significant increase in the recurrence-free duration (MD 42.76, 95% CI 12.41-73.11, p = 0.006) among patients undergoing EIT compared to dilation. CONCLUSION: Current data suggest EIT is associated with reduced odds of stricture recurrence among naïve anastomotic strictures. Large, prospective studies are needed to characterize the safety profile of EIT, address publication bias, and to explore multimodal therapies for refractory strictures.


Asunto(s)
Anastomosis Quirúrgica , Estenosis Esofágica , Esofagectomía , Gastrectomía , Complicaciones Posoperatorias , Humanos , Esofagectomía/efectos adversos , Esofagectomía/métodos , Gastrectomía/efectos adversos , Gastrectomía/métodos , Anastomosis Quirúrgica/efectos adversos , Estenosis Esofágica/etiología , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Constricción Patológica/etiología , Recurrencia , Dilatación/métodos
10.
Res Synth Methods ; 15(4): 627-640, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38494429

RESUMEN

BACKGROUND: Interrupted time series (ITS) studies contribute importantly to systematic reviews of population-level interventions. We aimed to develop and validate search filters to retrieve ITS studies in MEDLINE and PubMed. METHODS: A total of 1017 known ITS studies (published 2013-2017) were analysed using text mining to generate candidate terms. A control set of 1398 time-series studies were used to select differentiating terms. Various combinations of candidate terms were iteratively tested to generate three search filters. An independent set of 700 ITS studies was used to validate the filters' sensitivities. The filters were test-run in Ovid MEDLINE and the records randomly screened for ITS studies to determine their precision. Finally, all MEDLINE filters were translated to PubMed format and their sensitivities in PubMed were estimated. RESULTS: Three search filters were created in MEDLINE: a precision-maximising filter with high precision (78%; 95% CI 74%-82%) but moderate sensitivity (63%; 59%-66%), most appropriate when there are limited resources to screen studies; a sensitivity-and-precision-maximising filter with higher sensitivity (81%; 77%-83%) but lower precision (32%; 28%-36%), providing a balance between expediency and comprehensiveness; and a sensitivity-maximising filter with high sensitivity (88%; 85%-90%) but likely very low precision, useful when combined with specific content terms. Similar sensitivity estimates were found for PubMed versions. CONCLUSION: Our filters strike different balances between comprehensiveness and screening workload and suit different research needs. Retrieval of ITS studies would be improved if authors identified the ITS design in the titles.


Asunto(s)
Minería de Datos , Almacenamiento y Recuperación de la Información , Análisis de Series de Tiempo Interrumpido , MEDLINE , PubMed , Motor de Búsqueda , Minería de Datos/métodos , Humanos , Almacenamiento y Recuperación de la Información/métodos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Algoritmos , Proyectos de Investigación
11.
J Clin Epidemiol ; 170: 111331, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38552725

RESUMEN

OBJECTIVES: To generate a bank of items describing application and interpretation errors that can arise in pairwise meta-analyses in systematic reviews of interventions. STUDY DESIGN AND SETTING: MEDLINE, Embase, and Scopus were searched to identify studies describing types of errors in meta-analyses. Descriptions of errors and supporting quotes were extracted by multiple authors. Errors were reviewed at team meetings to determine if they should be excluded, reworded, or combined with other errors, and were categorized into broad categories of errors and subcategories within. RESULTS: Fifty articles met our inclusion criteria, leading to the identification of 139 errors. We identified 25 errors covering data extraction/manipulation, 74 covering statistical analyses, and 40 covering interpretation. Many of the statistical analysis errors related to the meta-analysis model (eg, using a two-stage strategy to determine whether to select a fixed or random-effects model) and statistical heterogeneity (eg, not undertaking an assessment for statistical heterogeneity). CONCLUSION: We generated a comprehensive bank of possible errors that can arise in the application and interpretation of meta-analyses in systematic reviews of interventions. This item bank of errors provides the foundation for developing a checklist to help peer reviewers detect statistical errors.


Asunto(s)
Metaanálisis como Asunto , Humanos , Revisiones Sistemáticas como Asunto/métodos , Revisiones Sistemáticas como Asunto/normas , Interpretación Estadística de Datos , Proyectos de Investigación/normas
12.
World J Surg ; 48(3): 723-728, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-38323663

RESUMEN

BACKGROUND: Surgeon-industry collaboration is a key driver of advancement in surgical technology and practice. Disclosures of financial relationships between investigators and industries are important to ensure transparent and critical evaluation of literature. METHODS: All American cardiothoracic (CT) surgeons who published in three major CT surgery journals in 2019 were identified. Whether these surgeons disclosed any conflicts of interest was recorded and compared to actual payments received within 5 years of publication as reported by the Centers for Medicare and Medicaid Services data. RESULTS: In the study period, there were 1079 unique manuscripts involving 885 American CT surgeons as authors, which combined for 2719 author instances. Of these, 96.2% of authors (851 of 885) received payments from companies. The authors who received payments produced 2651 author instances (97.4%). Financial disclosure was reported in only 11.4% (301 of 2651) of these instances. In total, 851 surgeons received more than $187 million over 5 years, with the highest-paid surgeon receiving an average of over $5.9 million per year. The largest individual payments were from "Associated Research Funding," with over $115 million being paid to 277 surgeons over 5 years. The top paying company issued over $96.5 million to American CT surgeons over 5 years. CONCLUSIONS: Nearly all the reviewed publications in three top CT surgery journals were by surgeons who received payments from companies, but very few of these payments were recorded as potential conflicts of interest. A more consistent and robust policy of COI disclosure is needed to reduce perceptions of bias.


Asunto(s)
Especialidades Quirúrgicas , Cirujanos , Anciano , Humanos , Estados Unidos , Revelación , Conflicto de Intereses , Medicare
13.
World J Surg ; 48(4): 807-815, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38415883

RESUMEN

BACKGROUND: It is vital for national professional surgical societies to embrace diversity, inclusion, and equity. This study examines race and sex diversity in two Canadian surgical societies. METHODS: Websites of the Canadian Society of Cardiac Surgeons (CSCS) and the Canadian Association of General Surgeons (CAGS) and previous programs of their annual meetings were reviewed. Leadership positions, conference speakers, and award winners were categorized by race and sex. RESULTS: White males made up the largest category of Cardiac Surgery meeting speakers (73/142 [51%]), CAGS committee members (89/198 [45%]), CAGS past presidents (38/43 [88%]), and General Surgery meeting speakers (841/1472 [57%]). Of the 17 members that made up the CSCS board of directors and officers, 8 were White males (47%), 5 were BIPOC males (29%), 3 were White females (18%), and 1 was a BIPOC female (6%). Of the 42 members of the CAGS board of directors and advisory committee, 16 were White males (38%), 5 were BIPOC males (12%), 17 were White females (40%), and 4 were BIPOC females (10%). CONCLUSIONS: BIPOC individuals and females are underrepresented in both societies compared to White males. However, in CAGS, improvements in representation can be seen in recent years. It is important that both of these organizations continue to embrace diversity.


Asunto(s)
Sociedades Médicas , Cirujanos , Masculino , Humanos , Femenino , Canadá , Liderazgo
14.
BMC Med Res Methodol ; 24(1): 31, 2024 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-38341540

RESUMEN

BACKGROUND: The Interrupted Time Series (ITS) is a robust design for evaluating public health and policy interventions or exposures when randomisation may be infeasible. Several statistical methods are available for the analysis and meta-analysis of ITS studies. We sought to empirically compare available methods when applied to real-world ITS data. METHODS: We sourced ITS data from published meta-analyses to create an online data repository. Each dataset was re-analysed using two ITS estimation methods. The level- and slope-change effect estimates (and standard errors) were calculated and combined using fixed-effect and four random-effects meta-analysis methods. We examined differences in meta-analytic level- and slope-change estimates, their 95% confidence intervals, p-values, and estimates of heterogeneity across the statistical methods. RESULTS: Of 40 eligible meta-analyses, data from 17 meta-analyses including 282 ITS studies were obtained (predominantly investigating the effects of public health interruptions (88%)) and analysed. We found that on average, the meta-analytic effect estimates, their standard errors and between-study variances were not sensitive to meta-analysis method choice, irrespective of the ITS analysis method. However, across ITS analysis methods, for any given meta-analysis, there could be small to moderate differences in meta-analytic effect estimates, and important differences in the meta-analytic standard errors. Furthermore, the confidence interval widths and p-values for the meta-analytic effect estimates varied depending on the choice of confidence interval method and ITS analysis method. CONCLUSIONS: Our empirical study showed that meta-analysis effect estimates, their standard errors, confidence interval widths and p-values can be affected by statistical method choice. These differences may importantly impact interpretations and conclusions of a meta-analysis and suggest that the statistical methods are not interchangeable in practice.


Asunto(s)
Salud Pública , Humanos , Análisis de Series de Tiempo Interrumpido
15.
Artículo en Inglés | MEDLINE | ID: mdl-38237074

RESUMEN

INTRODUCTION: Competency-based training requires frequent assessment of residents' skills to determine clinical competence. This study reviews existing literature on procedure-specific competence assessment tools in orthopaedic surgery. METHODS: A systematic search of eight databases up to May 2023 was conducted. Two reviewers independently assessed validity evidence and educational utility of each assessment tool and evaluated studies' methodological quality. RESULTS: Database searching identified 2,556 unique studies for title and abstract screening. Full texts of 290 studies were reviewed; 17 studies met the inclusion criteria. Bibliography review identified another five studies, totaling 22 studies examining 24 assessment tools included in the analysis. These tools assessed various orthopaedic surgery procedures within trauma, sports medicine, spine, and upper extremity. Overall validity evidence was low across all studies, and was lowest for consequences and highest for content. Methodological quality of studies was moderate. Educational utility assessment was not explicitly done for most tools. DISCUSSION: The paucity of current procedure-specific assessment tools in orthopaedic surgery lacks the validity evidence required to be used reliably in high-stake summative assessments. Study strengths include robust methodology and use of an evidence-based validity evidence framework. Poor-quality existing evidence is a limitation and highlights the need for evidence-based tools across more subspecialties.


Asunto(s)
Competencia Clínica , Procedimientos Ortopédicos , Evaluación Educacional/métodos , Ortopedia
16.
Surgeon ; 22(2): 80-87, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37880073

RESUMEN

BACKGROUND: Cohesion between team members is critical for surgical performance. Our previous study has shown that the experience of working together (measured by Team Familiarity Score, TFS) helps reduce procedure time (PT). However, that conclusion was found in a relatively small sample size. With a large dataset including mixed general surgical procedures, we hypothesize that team familiarity makes a significant contribution to the improvement of team performance in complex cases, rather than in medium or basic surgical cases, measured by the procedure time, length of hospital stays (LOS), and surgical cost (COST). STUDY DESIGN: Patient demographics, operation, and patient outcome data of 922 general surgery cases were included. The cases were divided into three subgroups, including basic, medium, and complex surgical procedures. TFS and an Index of Difficulty of Surgery (IDS) were calculated for each procedure. Simple linear regression and random forest regressions were performed to analyze the association between surgical outcomes and all included independent variables (TFS, IDS, patient age, patient weight, and team size). RESULTS: When applied to complex cases, procedure time (r = -0.21) and cost (r = -0.23) dropped as TFS increases. In basic and medium surgical cases, increasing team familiarity failed to shorten the procedure time on average. CONCLUSION: Team familiarity is more important in complex cases because there is greater potential for improvement through team collaboration compared to basic and medium cases. Caution will be needed when applying team familiarity scores for examining surgical team performance in large databases with skewed to basic surgical cases.


Asunto(s)
Grupo de Atención al Paciente , Humanos , Tempo Operativo , Estudios Retrospectivos
17.
Artículo en Inglés | MEDLINE | ID: mdl-37981101

RESUMEN

OBJECTIVE: To determine whether targeted sampling (TS), which omits biopsy of triple- normal lymph nodes (LNs) on positron emission tomography, computed tomography, and endobronchial ultrasound (EBUS), is noninferior to systematic sampling (SS) of mediastinal LNs during EBUS for staging of patients with early-stage non-small cell lung cancer (NSCLC). METHODS: Patients who are clinical nodal (cN)0-N1 with suspected NSCLC eligible for EBUS based on positron emission tomography/computed tomography were enrolled in this prospective, multicenter trial. During EBUS, all patients underwent TS and then crossed over to SS, whereby at least 3 mediastinal LN stations (4R, 4L, 7) were routinely sampled. Gold standard of comparison was pathologic results. Based on the previous feasibility trial, a noninferiority margin of 6% was established for difference in missed nodal metastasis (MNM) incidence between TS and SS. The McNemar test on paired proportions was used to determine MNM incidence for each sampling method. Analysis was per-protocol using a level of significance of P < .05. RESULTS: Between November 2020 and April 2022, 91 patients were enrolled at 6 high-volume Canadian tertiary care centers. A total of 256 LNs underwent TS and SS. Incidence of MNM was 0.78% in SS and 2.34% in TS, with an absolute difference of 1.56% (95% confidence interval, -0.003% to 4.1%; P = .13). This falls within the noninferiority margin. A total of 6/256 LNs from 4 patients who were not sampled by TS were found to be malignant when sampled by SS. CONCLUSIONS: In high-volume thoracic endosonography centers, TS is not inferior to SS in nodal staging of early-stage NSCLC. This results in change of clinical management for a minority of patients.

18.
Simul Healthc ; 2023 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-37851383

RESUMEN

INTRODUCTION: A recent needs assessment in Canadian cardiac surgery programs identified the desire for a coronary artery bypass (CABG) and aortic valve replacement (AVR) simulation model for home practice. We aimed to develop and assess a portable, adjustable task trainer for cardiac surgical skills with high functional task alignment. METHODS: Intraoperative measurements were taken from patients undergoing elective CABG and AVR (N = 30). Measurements were taken in 3 axes and used to create a chest cavity that resembles the mediastinal constraints of a patient undergoing CABG and AVR. The task trainer is adjustable on the following 3 levels: (1) size of the incision, (2) depth of the chest, and (3) relative position of coronary artery or aortic valve model within the chest. Three groups (novices, intermediates, and experts) of cardiac surgery members evaluated the task trainer for functional task alignment and construct validity. RESULTS: The CABG and AVR model had high functional task alignment. There was a high satisfaction for both models and all participants would recommend the AVR and CABG model as an educational tool. Performance time significantly differed between the groups for both models (CABG: P = 0.032 and AVR: P = 0.001), as well as number of errors (CABG: P = 0.04 and AVR: P = 0.043). CONCLUSIONS: Using real patient data, we were able to develop an adjustable task trainer for training principles of CABG and AVR. Our pilot study provides preliminary sources of evidence for validity and future study will look to assess transferability of skill to the operating room.

19.
Plant Physiol ; 194(1): 51-66, 2023 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-37682865

RESUMEN

The plant cell wall is a complex and dynamic extracellular matrix. Plant primary cell walls are the first line of defense against pathogens and regulate cell expansion. Specialized cells deposit a secondary cell wall that provides support and permits water transport. The composition and organization of the cell wall varies between cell types and species, contributing to the extensibility, stiffness, and hydrophobicity required for its proper function. Recently, many of the proteins involved in the biosynthesis, maintenance, and remodeling of the cell wall have been identified as being post-translationally modified with lipids. These modifications exhibit diverse structures and attach to proteins at different sites, which defines the specific role played by each lipid modification. The introduction of relatively hydrophobic lipid moieties promotes the interaction of proteins with membranes and can act as sorting signals, allowing targeted delivery to the plasma membrane regions and secretion into the apoplast. Disruption of lipid modification results in aberrant deposition of cell wall components and defective cell wall remodeling in response to stresses, demonstrating the essential nature of these modifications. Although much is known about which proteins bear lipid modifications, many questions remain regarding the contribution of lipid-driven membrane domain localization and lipid heterogeneity to protein function in cell wall metabolism. In this update, we highlight the contribution of lipid modifications to proteins involved in the formation and maintenance of plant cell walls, with a focus on the addition of glycosylphosphatidylinositol anchors, N-myristoylation, prenylation, and S-acylation.


Asunto(s)
Proteínas de la Membrana , Procesamiento Proteico-Postraduccional , Membrana Celular/metabolismo , Proteínas de la Membrana/metabolismo , Pared Celular/metabolismo , Lípidos/química
20.
Animals (Basel) ; 13(18)2023 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-37760329

RESUMEN

This study used the Q-methodology approach to analyze perceptions of precision livestock farming (PLF) technology held by stakeholders directly or indirectly involved in the US swine industry. To see if stakeholders' perceptions of PLF changed over time as PLF is a rapidly evolving field, we deliberately followed up with stakeholders we had interviewed 6 months earlier. We identified three distinct points of view: PLF improves farm management, animal welfare, and laborer work conditions; PLF does not solve swine industry problems; PLF has limitations and could lead to data ownership conflict. Stakeholders with in-depth knowledge of PLF technology demonstrated elevated levels of optimism about it, whereas those with a basic understanding were skeptical of PLF claims. Despite holding different PLF views, all stakeholders agreed on the significance of training to enhance PLF usefulness and its eventual adoption. In conclusion, we believe this study's results hold promise for helping US swine industry stakeholders make better-informed decisions about PLF technology implementation.

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