Face, Content, and Construct Validity Evaluation of Simulation Models in General Surgery Laparoscopic Training and Education: A Systematic Review.

BACKGROUND: Laparoscopic technical surgical skills (LTS) are considered a fundamental competence for General Surgery residents. Several simulation tools (ST) have been explored to develop LTS. Although a plethora of systematic reviews evaluate the translation of LTS developed in simulation to real surgery, there is a lack of evidence that clarifies effectiveness of different validated ST in acquisition of LTS in surgical residents. The aim of this systematic review (SR) is to summarize published evidence on ST validation used for surgery education and training. METHODS: A protocol was published in PROSPERO. A SR was carried out following PRISMA guidelines. Complete published articles in English or Spanish that validate either content or construct, plus another form of validation of ST to acquire LTS in general surgery were included. Articles that used only one validation or did not validate an ST were excluded. RESULTS: 1052 publications were initially identified across all searched databases. Title review identified 204 studies eligible for full text screening. 10 studies were included for final review. Two studies assessed both face and content, 4 face and construct, and 4 face, content and construct validity. None of the studies presented comparable outcomes due to metrics variation and scores used for the validation strategies. CONCLUSIONS: This study assessed validated laparoscopic simulation models, particularly in content and construct validity. Articles reported an increased use of simulation models in laparoscopic training with positive feedback from trainees, but few studies reported validation of training model. Validation strategies are not standardized, limiting comparability between them.

Implications of human-wildlife conflict on the diet of an endangered avian top predator in the northern Andes.

Conflicts between rural people and the Endangered Black-and-chestnut Eagle (Spizaetus isidori) are a prominent conservation concern in the northern Andes, as at least 60 eagles were poached between 2000 and 2022 in response to poultry predation. Here, we conducted direct observations to analyze the Black-and-chestnut Eagle diet and evaluated how forest cover affects the feeding habits of the species during nestling-rearing periods in 16 nests located in different human-transformed Andean landscapes of Ecuador and Colombia. We analyzed 853 prey items (46 species) delivered to nestlings. We used Generalized Linear Models to test whether the percent forest cover calculated within varying buffer distances around each nest and linear distances from the nest to the nearest settlement and pasture areas were predictors of diet diversity and biomass contribution of prey. Forest cover was not a factor that affected the consumption of poultry; however, the eagle regularly preyed on chickens (Gallus gallus) (i.e., domestic Galliformes) which were consumed by 15 of the 16 eagle pairs, with biomass contributions (14.57% ± 10.55) representing 0.6-37% of the total prey consumed. The Black-and-chestnut Eagle is an adaptable generalist able to switch from mammalian carnivores to guans (i.e., wild Galliformes) in human-dominated landscapes, and eagles nesting in sites with low forest cover had a less diverse diet than those in areas with more intact forests. Management actions for the conservation of this avian top predator require studies on the eagle's diet in areas where human persecution is suspected or documented, but also maintaining forest cover for the wild prey of the species, development of socio-economic and psychological assessments on the drivers behind human-eagle conflicts, and the strengthening of technical capacities of rural communities, such as appropriate poultry management.

Viability and characterization trial of a novel method as an alternative to formaldehyde and Walter-Thiel cadaveric preservation for medical education and surgical simulation.

INTRODUCTION: Despite its toxic and carcinogenic nature, formaldehyde is a widely used reactant for specimen preservation. With the need of specimens for both anatomical and surgical training, alternative preservation solutions (PS) have been proposed, however, their use is limited due to high costs and complexity. Hence, a new formaldehyde-free solution (FFS) is evaluated as a potential alternative for anatomical and surgical training. METHODS: Qualitative and Quantitative data were acquired. Specimens preserved using three different methods were selected. Flexibility was measured by joints goniometry and pneumoperitoneum pressures were evaluated followed by an exploratory laparoscopy. Undergraduate student's perceptions on cadavers preserved with different PS were obtained using surveys and focus groups. RESULTS: The main reason why cadaveric specimens were considered as useful tools was the perceived interaction with real tissues and the 'practical' concept of getting in touch with what students would be facing in the future as physicians, what we call "hands on" activities. FFS treated specimens showed better joint-movement ranges in comparison to other methods and pneumoperitoneum was acquired after 5mmHg CO2 pressure. Students appreciated working with corpses regardless the technique used, however FFS specimens were defined as less uncomfortable, while presenting no sensory discomfort. CONCLUSIONS: Even though alternative PS are effective, high costs and complexity restrict their usage. Cadavers preserved with FFS had similar range of movements compared with Thiel. Students preferred to work with FFS rather than FF due to flexibility, color, and no sensorial hassles. Thus, we propose FFS as viable alternative to traditional PS.

Fantastic lizards and where to find them: cis-Andean microteiids (Squamata: Alopoglossidae amp; Gymnophthalmidae) from the Colombian Orinoquia and Amazonia.

Although Colombia is perceived as one of the most diverse countries in reptiles, the distribution of many microteiid lizards of the Alopoglossidae and Gymnophthalmidae families is still poorly known. This is particularly true for those species in the cis-Andean regions, in part due to the remoteness or socio-political issues within some of these territories. In order to elucidate the diversity and distribution of the cis-Andean microteiids in Colombia, in this study we present a review based on the examination of specimens deposited in the reptile collection at Instituto de Investigacin Alexander von Humboldt, one of the most important Colombian biological collections, and data from the literature. We reported a total of 29 taxa, in which three are new records for Colombia and three are range extensions. Two species were assigned to species complex because their morphological determination was non-conclusive, and three were identified just to genus, since they may correspond to more than one entity or be currently non-described. We found that nine species are distributed in both the Amazonia and Orinoquia regions, nine are currently only present in the Amazonia and seven are in the Orinoquia. Based on our data, we highlight the importance of using local museums to increase the taxonomic and geographic data coverage, we discuss the taxonomic difficulties for some taxa, as well as the potential for future research and their constraints. Finally, we present a taxonomic key for the identification of the microteiids present in the Orinoquia and Amazonia regions of Colombia.

Viability and characterization trial of a novel method as an alternative to formaldehyde and Walter-Thiel cadaveric preservation for medical education and surgical simulation.

INTRODUCTION: Despite its toxic and carcinogenic nature, formaldehyde is a widely used reactant for specimen preservation. With the need of specimens for both anatomical and surgical training, alternative preservation solutions (PS) have been proposed, however, their use is limited due to high costs and complexity. Hence, a new formaldehyde-free solution (FFS) is evaluated as a potential alternative for anatomical and surgical training. METHODS: Qualitative and Quantitative data were acquired. Specimens preserved using three different methods were selected. Flexibility was measured by joints goniometry and pneumoperitoneum pressures were evaluated followed by an exploratory laparoscopy. Undergraduate student's perceptions on cadavers preserved with different PS were obtained using surveys and focus groups. RESULTS: The main reason why cadaveric specimens were considered as useful tools was the perceived interaction with real tissues and the 'practical' concept of getting in touch with what students would be facing in the future as physicians, what we call "hands on" activities. FFS treated specimens showed better joint-movement ranges in comparison to other methods and pneumoperitoneum was acquired after 5mmHg CO2 pressure. Students appreciated working with corpses regardless the technique used, however FFS specimens were defined as less uncomfortable, while presenting no sensory discomfort. CONCLUSIONS: Even though alternative PS are effective, high costs and complexity restrict their usage. Cadavers preserved with FFS had similar range of movements compared with Thiel. Students preferred to work with FFS rather than FF due to flexibility, color, and no sensorial hassles. Thus, we propose FFS as viable alternative to traditional PS.

An environmental magnetism approach to assess impacts of land-derived sediment disturbances on coral reef ecosystems (Cartagena, Colombia).

We used environmental magnetism methods to study recently deposited marine sediments from the estuarine ecosystems on the Caribbean coast of Colombia. Cartagena region has undergone an increasing sediment load during the last decades via sediment plumes from Magdalena River and its distributary man-made channel. Concentration dependent magnetic parameters show an increasing abundance of ferrimagnetic minerals on the uppermost sediments on sites located close to the continent (remanent magnetization SIRM = 5.4-9.5 × 10-3Am2 kg-1) as well as faraway sites (SIRM = 0.5-1.7 × 10-3Am2 kg-1 near Rosario Islands coral reef complex). The magnetic grain size and mineralogy along the cores are variable, showing the dominance of the magnetite-like minerals (remanent coercivity Hcr = 34.3-45.3 mT), with a minor contribution of high-coercivity minerals (Hcr = 472-588 mT). In addition, there is a moderate enrichment of elements Cu, Mo, and Zn (enrichment factor EF = 1.5-3.8) that indicates the additional land-derived contribution on sediments. The environmental magnetism approach, which shows significant signals of magnetic minerals and trace elements, is a reliable tool to prove the presence of continental sediment supply in coral reef ecosystems.

Coral reefs chronically exposed to river sediment plumes in the southwestern Caribbean: Rosario Islands, Colombia.

Politicians do not acknowledge the devastating impacts riverine sediments can have on healthy coral reef ecosystems during environmental debates in Caribbean countries. Therefore, regional and/or local decision makers do not implement the necessary measures to reduce fluvial sediment fluxes on coral reefs. The Magdalena River, the main contributor of continental fluxes into the Caribbean Sea, delivers water and sediment fluxes into the Rosario Islands National Park, an important marine protected area in the southwestern Caribbean. Until now, there is no scientific consensus on the presence of sediment fluxes from the Magdalena River in the coral reefs of the Rosario Islands. Our hypothesis is that high sediment and freshwater inputs from the Magdalena have been present at higher acute levels during the last decade than previously thought, and that these runoff pulses are not flashy. We use in-situ calibrated MODIS satellite images to capture the spatiotemporal variability of the distribution of suspended sediment over the coral reefs. Furthermore, geochemical data are analyzed to detect associated sedimentation rates and pollutant dispersion into the coastal zone. Results confirm that turbidity levels have been much higher than previous values presented by national environmental authorities on coral reefs off Colombia over the last decade. During the 2003-2013-period most of the Total Suspended Sediments (TSS) values witnessed in the sampled regions were above 10mg/l, a threshold value of turbidity for healthy coral reef waters. TSS concentrations throughout the analyzed time were up to 62.3mg/l. Plume pulses were more pronounced during wet seasons of La Niña events in 2002-2003, 2007-2008, and 2009-2010. Reconstructed time series of MODIS TSS indicates that coral reef waters were exposed to river plumes between 19.6 and 47.8% of the entire period of analysis (2000-2013). Further analyses of time series of water discharge and sediment load into the coastal zone during the last two decades show temporal increases in water discharge and sediment load of 28% and 48%, respectively. (210)Pb dating results from two cores indicate sedimentation rates of ~0.75 cm/y of continentally exported clastic muddy sediments that are being deposited on the carbonatic shelf. The cores contain sediments with heavy metals and their concentrations are frequently above the ecologically accepted standards. Overall, the last decade has witnessed stronger magnitudes in fluvial fluxes to the coastal region, which probably coincide with associated declines in healthy coral cover and water quality. Our results emphasize the importance of local stressors, such as runoff and dispersion of turbid plumes, as opposed to ocean warming, disease and hurricanes, which have played a larger role on other coral reefs in the Caribbean. Coral reef management across the southwestern Caribbean, a coastal region influenced by continental fluxes of numerous rivers flowing from the Andes, may only be effective when land and marine-based stressors are simultaneously mitigated.