Impact of nitrogen (N) and phosphorus (P) enrichment and skewed N:P stoichiometry on the skeletal formation and microstructure of symbiotic reef corals.

Reported divergent responses of coral growth and skeletal microstructure to the nutrient environment complicate knowledge-based management of water quality in coral reefs. By re-evaluating published results considering the taxonomy of the studied corals and the N:P stoichiometry of their nutrient environment, we could resolve some of the major apparent contradictions. Our analysis suggests that Acroporids behave differently to several other common genera and show distinct responses to specific nutrient treatments. We hypothesised that both the concentrations of dissolved inorganic N and P in the water and their stoichiometry shape skeletal growth and microstructure. We tested this hypothesis by exposing Acropora polystoma fragments to four nutrient treatments for > 10 weeks: high nitrate/high phosphate (HNHP), high nitrate/low phosphate (HNLP), low nitrate/high phosphate (LNHP) and low nitrate/low phosphate (LNLP). HNHP corals retained high zooxanthellae densities and their linear extension and calcification rates were up to ten times higher than in the other treatments. HNLP and LNLP corals bleached through loss of symbionts. The photochemical efficiency (Fv/Fm) of residual symbionts in HNLP corals was significantly reduced, indicating P-starvation. Micro-computed tomography (µCT) of the skeletal microstructure revealed that reduced linear extension in nutrient limited or nutrient starved conditions (HNLP, LNHP, LNLP) was associated with significant thickening of skeletal elements and reduced porosity. These changes can be explained by the strongly reduced linear extension rate in combination with a smaller reduction in the calcification rate. Studies using increased skeletal density as a proxy for past thermal bleaching events should consider that such an increase in density may also be associated with temperature-independent response to the nutrient environment. Furthermore, the taxonomy of corals and seawater N:P stoichiometry should be considered when analysing and managing the impacts of nutrient pollution. Supplementary Information: The online version contains supplementary material available at 10.1007/s00338-022-02223-0.

Urolithiasis in pregnancy: Advances in imaging modalities and evaluation of current trends in endourological approaches.

OBJECTIVE: Given the challenges involved in diagnosis and treatment of pregnant women with urolithiasis, we aim to review the imaging modalities and current endourological management of these patients. MATERIALS AND METHODS: We performed a review of the available literature on urolithiasis in pregnancy. This included evaluation, diagnostic imaging, and therapeutic options. The databases we searched from included Google Scholar and PubMed. A total of 346 abstracts were screened. After our inclusion/exclusion criteria were met, we were left with 42 sources: 18 retrospective studies, 10 reviews/meta-analyses, 8 sets of guidelines, 5 randomized control trials, and 1 prospective cohort. RESULTS: We begin our review with the literature available on the safety and efficacy of imaging modalities in the surgical planning for urolithiasis in pregnant patients. This includes renal ultrasound, abdominal x-ray, computed tomography scan, and magnetic resonance imaging. While computed tomography may result in an added radiation exposure, with possible safety concerns, magnetic resonance imaging seems to be safer, however a less sensitive test. We next describe safety, efficacy, and outcomes of various surgical interventions for urolithiasis in pregnant patients. This encompasses ureteral stenting, percutaneous nephrostomy, ureteroscopy, extracorporeal shock wave lithotripsy, and percutaneous nephrolithotomy. Ureteroscopy is a safer approach, but percutaneous nephrolithotomy offers higher stone-free rates. Using an evidence-based approach, we propose an algorithm for management of the pregnant women with renal colic. CONCLUSION: Management of the pregnant women with suspected urolithiasis is a unique challenge for healthcare providers. A multi-disciplinary approach should be taken to optimize outcomes through an evidence-based approach.

[Online surgical education adopted among urology residency programs in response to COVID-19: A pilot study]. / La educación quirúrgica en línea implementada en los programas de residencia urológica como respuesta a la COVID-19: estudio piloto.

Objective: To understand the residents' perceptions of the, COVID-19 driven, newly implemented online learning systems adopted among accredited urology residency programs nationwide, and their sustainability following the pandemic era. Materials and methods: A survey was designed and dispersed to urology program coordinators and directors to distribute to their residents.In the survey, online education models was the all-encompassing term to describe any form of resident education that occurred online. Anonymous surveys were exported from Survey Monkey and data was analyzed for statistical significance. Results: Over 70% of urology residents agreed or were neutral to the statement that online education models were equivalent to in-person learning. Only 13% of residents stated that online learning should not be continued following the pandemic. Several different parameters were assessed, and only 5 of them showed statistical significance. Stress, personal engagement, interpersonal communication efficiency and non-verbal cues were all lower with online education models. The only attribute that was scored higher by residents was network connectivity issues. Conclusions: An overwhelming majority of urology residents in the United States believe online education models should continue to be adopted once the pandemic is over.

Online surgical education adopted among urology residency programs in response to COVID-19: A pilot study.

OBJECTIVE: To understand the residents' perceptions of the, COVID-19 driven, newly implemented online learning systems adopted among accredited urology residency programs nationwide, and their sustainability following the pandemic era. MATERIALS AND METHODS: A survey was designed and dispersed to urology program coordinators and directors to distribute to their residents. In the survey, Online education models was the all-encompassing term to describe any form of resident education that occurred online. Anonymous surveys were exported from Survey Monkey and data was analyzed for statistical significance. RESULTS: Over 70% of urology residents agreed or were neutral to the statement that Online education models were equivalent to in-person learning. Only 13% of residents stated that online learning should not be continued following the pandemic. Several different parameters were assessed, and only 5 of them showed statistical significance. Stress, personal engagement, interpersonal communication efficiency and non-verbal cues were all lower with online education models. The only attribute that was scored higher by residents was network connectivity issues. CONCLUSIONS: An overwhelming majority of urology residents in the United States believe Online education models should continue to be adopted once the pandemic is over.

Urolitiasis en el embarazo: avances en las modalidades de imagen y evaluación de las tendencias actuales en los abordajes endourológicos / Urolithiasis in pregnancy: Advances in imaging modalities and evaluation of current trends in endourological approaches

Objetivo Dados los desafíos inherentes al diagnóstico y tratamiento de las mujeres embarazadas con urolitiasis, nos proponemos revisar las modalidades de imagen y el manejo endourológico actual de estas pacientes. Materiales y métodos se realizó una revisión de la literatura disponible sobre la urolitiasis en el embarazo. Esto incluyó la evaluación, el diagnóstico por imágenes y las opciones terapéuticas. Las bases de datos en las que se realizó la búsqueda fueron Google Scholar y PubMed. Se examinaron un total de 346 resúmenes. Tras aplicar los criterios de inclusión y exclusión quedaron 42 publicaciones: 18 estudios retrospectivos, 10 revisiones o metaanálisis, 8 conjuntos de directrices, 5 ensayos de control aleatorizados y una cohorte prospectiva. Resultados Iniciamos nuestra revisión con la literatura disponible sobre la seguridad y eficacia de las modalidades de imagen en la planificación quirúrgica de la urolitiasis en pacientes embarazadas. Esto incluye la ecografía renal, la radiografía abdominal, la tomografía computarizada y la resonancia magnética. Mientras que la tomografía computarizada puede suponer una exposición mayor a la radiación, con posibles problemas de seguridad, la resonancia magnética, aunque es una prueba menos sensible, parece ser más segura. A continuación se describen la seguridad, la eficacia y los resultados de diversas intervenciones quirúrgicas para la urolitiasis en pacientes embarazadas, como son la colocación de un stent ureteral, la nefrostomía percutánea, la ureteroscopia, la litotricia extracorpórea por ondas de choque y la nefrolitotomía percutánea. La ureteroscopia es un abordaje más seguro, pero la nefrolitotomía percutánea ofrece tasas mayores de ausencia de cálculos. Utilizando un enfoque basado en la evidencia, proponemos un algoritmo para el manejo de las mujeres embarazadas con cólico renal (AU)

Objective Given the challenges involved in diagnosis and treatment of pregnant women with urolithiasis, we aim to review the imaging modalities and current endourological management of these patients. Materials and methods We performed a review of the available literature on urolithiasis in pregnancy. This included evaluation, diagnostic imaging, and therapeutic options. The databases we searched from included Google Scholar and PubMed. A total of 346 abstracts were screened. After our inclusion/exclusion criteria were met, we were left with 42 sources: 18 retrospective studies, 10 reviews/meta-analyses, 8 sets of guidelines, 5 randomized control trials, and one prospective cohort. Results We begin our review with the literature available on the safety and efficacy of imaging modalities in the surgical planning for urolithiasis in pregnant patients. This includes renal ultrasound, abdominal x-ray, computed tomography scan, and magnetic resonance imaging. While computed tomography may result in an added radiation exposure, with possible safety concerns, magnetic resonance imaging seems to be safer, however a less sensitive test. We next describe safety, efficacy, and outcomes of various surgical interventions for urolithiasis in pregnant patients. This encompasses ureteral stenting, percutaneous nephrostomy, ureteroscopy, extracorporeal shock wave lithotripsy, and percutaneous nephrolithotomy. Ureteroscopy is a safer approach, but percutaneous nephrolithotomy offers higher stone-free rates. Using an evidence-based approach, we propose an algorithm for management of the pregnant women with renal colic. Conclusion Management of the pregnant women with suspected urolithiasis is a unique challenge for healthcare providers. A multi-disciplinary approach should be taken to optimize outcomes through an evidence-based approach (AU)

La educación quirúrgica en línea implementada en los programas de residencia urológica como respuesta a la COVID-19: estudio piloto / Online surgical education adopted among urology residency programs in response to COVID-19: A pilot study

Objetivo: Comprender la percepción de los residentes respecto a los sistemas de aprendizaje en línea, los cuales, impulsados por la pandemia de la COVID-19, han sido recientemente implementados a nivel nacional en los programas de residencia urológica acreditados. Adicionalmente, nos proponemos analizar su sostenibilidad tras la era de la pandemia.Material y métodos: Se diseñó una encuesta para, a través de los coordinadores y directores de programas de urología, difundirla a los residentes de urología.En la encuesta, los modelos de educación en línea englobaron cualquier forma de educación recibida por los residentes que se diera en línea. Las encuestas anónimas se exportaron de Survey Monkey y se analizaron los datos para determinar la significación estadística.Resultados: Más del 70% de los residentes de urología estuvieron de acuerdo, o mostraron una actitud neutral, ante la afirmación de que los modelos de educación en línea eran equivalentes al aprendizaje presencial. Solo el 13% de los residentes afirmaron que el aprendizaje en línea no debería continuar tras la pandemia. Se evaluaron diversos parámetros, y solo 5 de ellos mostraron significación estadística. El estrés, el compromiso personal, la eficacia de la comunicación interpersonal y las señales no verbales fueron más bajos para los modelos de educación en línea. El único aspecto al que los residentes dieron mayor puntuación fue el de los problemas de conectividad a una red.Conclusiones: La gran mayoría de los residentes de urología en Estados Unidos cree que los modelos de educación en línea deben mantenerse una vez terminada la pandemia. (AU)

Objective: To understand the residents’ perceptions of the, COVID-19 driven, newly implemented online learning systems adopted among accredited urology residency programs nationwide, and their sustainability following the pandemic era.Materials and methods: A survey was designed and dispersed to urology program coordinators and directors to distribute to their residents.In the survey, online education models was the all-encompassing term to describe any form of resident education that occurred online. Anonymous surveys were exported from Survey Monkey and data was analyzed for statistical significance.Results: Over 70% of urology residents agreed or were neutral to the statement that online education models were equivalent to in-person learning. Only 13% of residents stated that online learning should not be continued following the pandemic. Several different parameters were assessed, and only 5 of them showed statistical significance. Stress, personal engagement, interpersonal communication efficiency and non-verbal cues were all lower with online education models. The only attribute that was scored higher by residents was network connectivity issues.Conclusions: An overwhelming majority of urology residents in the United States believe online education models should continue to be adopted once the pandemic is over. (AU)