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1.
Plants (Basel) ; 13(9)2024 May 02.
Article in English | MEDLINE | ID: mdl-38732482

ABSTRACT

Sweet potato leaf curl virus (SPLCV) is a whitefly-transmitted begomovirus infecting sweetpotato and other morning glory (Convolvulaceae) species worldwide. The virus is widespread at the USDA, ARS, U.S. Vegetable Laboratory (USVL), and testing of germplasm maintained in the breeding program indicates nearly 100% infection in storage roots of materials propagated for at least four years. Prior to the public release of new germplasm, viruses must be eliminated via laborious and time-consuming meristem-tip culture. The identification of virus-free seedlings early in the selection process can offer an alternative to meristem-tip culture. In this study, we investigated the transmission of SPLCV over two years of consecutive field plantings (early and late) of sweetpotato. While SPLCV is endemic at the USVL, virus transmission pressure over the typical cultivation season is unknown, and avoidance of virus transmission paired with the selection and maintenance of clean material may be a viable alternative to virus elimination. In 2022, the storage roots of 39 first-year seedling (FYS) selections were tested for SPLCV after early-season cultivation, revealing a single selection (2.6%) with a positive test. Similar testing was conducted in 2023 with no SPLCV-positive FYS selections detected. To further assess SPLCV acquisition in the field, replicated late-season plantings of each selected FYS (n = 37) were monitored from planting to harvest. Testing was conducted at 60 and 120 days after planting (DAP). Approximately 35% of the bulk samples were infected at 60 DAP, and infection increased to 52.3% by 120 DAP. Testing of individuals within selected positive bulked samples did not support 100% infection at harvest. Altogether, these results demonstrate that SPLCV transmission during early planting is sufficiently low to facilitate the maintenance of virus-free selections, offering an alternative to virus cleaning and a cultivation strategy that may be leveraged for production.

2.
Dev Sci ; : e13495, 2024 Mar 07.
Article in English | MEDLINE | ID: mdl-38450811

ABSTRACT

Feeling loved by one's caregiver is essential for individual flourishing (i.e., high levels of psychological well-being in multiple dimensions). Although similar constructs are found to benefit adolescent well-being, research that directly tests parental love as a feeling from the recipient's perspective is rare. Historically, parental love has been measured using single-assessment methods and assumed to be a stable, trait-like characteristic; yet, like any feeling, it may fluctuate in meaningful ways on a day-to-day basis-the implications of which are unknown. Using a sample of 150 adolescents (59.3% female; ages 14-16), this study estimated level (person's mean level across days) and instability (fluctuations across days) of feeling loved by a caregiver across 21 days for each adolescent, and then examined their prospective effects on adolescent flourishing 1 year later. After controlling for demographics (adolescent age, gender, family income, and parent's sex) and variable baseline levels, feeling more loved by one's caregiver in daily life significantly predicted higher levels of flourishing in two global measures 1 year later. Moreover, level and instability of feeling loved by one's caregiver played different roles for different dimensions of flourishing: higher levels significantly predicted higher levels of autonomy, purpose in life, and personal growth, whereas higher instability significantly predicted lower levels of positive relations with others and environmental mastery. Findings emphasized the importance of considering daily dynamics of feeling loved by one's caregiver and demonstrated that level (of feeling loved) is particularly important for intrapersonal aspects while instability is particularly important for interpersonal aspects of flourishing. RESEARCH HIGHLIGHTS: Adolescents feeling more loved by their caregiver in daily life had higher levels of overall flourishing 1 year later. Level (of feeling loved) is particularly important for intrapersonal aspects of adolescent flourishing, including autonomy, purpose in life, and personal growth. Stability (of feeling loved) is particularly important for interpersonal aspects of adolescent flourishing, including positive relations with others and environmental mastery.

3.
Emotion ; 24(2): 357-369, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37616108

ABSTRACT

Parents are inundated with suggestions to improve their relationships with their children and promote child development, but improving caregiver well-being is often overlooked despite being considered one of the most important methods to promote healthy child development. Drawing on the robust literature on the emotional and relationship benefits of gratitude, we present two studies demonstrating the advantages of gratitude for parents' well-being and family functioning. First, in a 7-day daily experience study conducted in 2018 (N = 270), daily gratitude predicted greater well-being and family functioning, controlling for daily happiness, coder-rated care difficulty, and sociodemographics. Second, in a short-term longitudinal experiment conducted in 2018 (N = 619), participants were randomly assigned to write a gratitude letter or to complete a control activity. In this study, expressing gratitude predicted greater well-being and family functioning 1 week later via increases in positive emotions. Notably, across both studies neither felt nor expressed gratitude referred to one's children; however, the results of our studies suggest that gratitude in general improves parent-child relationships and family well-being. This work provides insights regarding ways to improve parents' well-being without requiring greater effort, energy, or attention to one's children, and it suggests that promoting parents' gratitude in general may benefit the entire family. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Emotions , Parents , Humans , Happiness , Parent-Child Relations , Child Development
4.
Tech Coloproctol ; 27(5): 361-371, 2023 05.
Article in English | MEDLINE | ID: mdl-36933141

ABSTRACT

BACKGROUND: Methylene blue staining of the resected specimen has been described as an alternative to the conventional palpation and visual inspection method to improve lymph node harvest. This meta-analysis evaluates the usefulness of this technique in surgery for rectal cancer, particularly after neoadjuvant therapy. METHODS: Randomized controlled trials (RCTs) comparing lymph node harvest in methylene blue-stained rectal specimens to those of unstained specimens were identified from the Medline, Embase, and Cochrane databases. Non-randomized studies and those with only colonic resections were excluded. The quality of RCTs was assessed using Cochrane's risk of bias tool. A weighted mean difference (WMD) was calculated for overall harvest, harvest after neoadjuvant therapy, and metastatic nodal yield. In contrast, the risk difference (RD) was calculated to compare yields of less than 12 lymph nodes between the stained and unstained specimens. RESULTS: Study selection comprised seven RCTs with 343 patients in the unstained group and 337 in the stained group. Overall lymph node harvest and harvest after neoadjuvant therapy were significantly higher in stained specimens with a WMD of 13.4 and 10.6 and a 95% confidence interval (CI) of 9.5-17.2 and 4.8-16.3, respectively. Harvest of metastatic lymph nodes was significantly higher in the stained group (WMD 1.0, 95% CI 0.6-1.4). The yield of less than 12 lymph nodes was significantly higher in the unstained group with RD of 0.292 and 95% CI of 0.182-0.403. CONCLUSION: Despite a small number of patients, this meta-analysis confirms improved lymph node harvest in surgical specimens stained with methylene blue compared with unstained specimens.


Subject(s)
Lymph Node Excision , Rectal Neoplasms , Humans , Lymph Node Excision/methods , Methylene Blue , Lymph Nodes/surgery , Lymph Nodes/pathology , Rectal Neoplasms/surgery , Rectal Neoplasms/pathology , Rectum/pathology , Neoplasm Staging
6.
Clin Colon Rectal Surg ; 35(4): 263-264, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35966975
7.
Int J Med Robot ; 18(5): e2431, 2022 Oct.
Article in English | MEDLINE | ID: mdl-35666815

ABSTRACT

INTRODUCTION: The purpose of this study was to evaluate outcomes in elderly patients (age ≥ 65 years) undergoing robotic colorectal surgery (RCRS) in comparison with non-elderly patients. MATERIALS AND METHODS: Data was collected on elderly and non-elderly patients who underwent RCRS from a prospectively maintained database. RESULTS: A total of 89 elderly and 73 non-elderly patients were identified. No statistically significant differences in postoperative complication, reoperation, wound infection, anastomotic leak or mortality were observed. The median length of stay was 1 day longer in elderly patients (p = 0.007). Subgroup analysis of octogenarians demonstrated outcomes that compared favourably with younger patients. CONCLUSION: RCRS in elderly patients is safe and effective, with outcomes that do not differ significantly with younger patients. Older age should not be considered to be a specific exclusion criteria for RCRS. To our knowledge, this study represents the largest in the literature to examine outcomes specifically in elderly patients undergoing RCRS.


Subject(s)
Colorectal Surgery , Laparoscopy , Robotic Surgical Procedures , Aged , Aged, 80 and over , Humans , Length of Stay , Middle Aged , Postoperative Complications/etiology , Reoperation , Retrospective Studies , Robotic Surgical Procedures/adverse effects , Treatment Outcome
8.
Int J Surg Open ; 43: 100488, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35578663

ABSTRACT

Necrotising fasciitis (NF) is a severe soft tissue infection that is associated with a high risk of morbidity and mortality. During the coronavirus disease 19 (COVID-19) pandemic, the population has been actively discouraged from presenting to emergency medical services unless absolutely necessary. While this was an important step in allowing for preservation of limited resources in a time of crisis, it may have resulted in immeasurable 'secondary victims' of the pandemic as patients with time-critical conditions delay hospital presentation. In this case series, we describe three patients that noted symptoms of soft tissue infection, but delayed seeking healthcare advice due to concerns regarding COVID-19 exposure. All three progressed to NF, requiring highly morbid wide surgical debridement and prolonged hospital admission, with a high risk of potential mortality. The findings of this series demonstrate the importance of consistently delivering appropriate and timely healthcare interventions to patients with non-COVID-19-related conditions. While efforts must be made to ensure preservation of valuable healthcare resources in a global pandemic, patients must also be empowered to seek timely care for non-COVID-19-related conditions even in this time of crisis.

9.
Emotion ; 22(5): 861-873, 2022 Aug.
Article in English | MEDLINE | ID: mdl-32658506

ABSTRACT

Feeling loved has many benefits, but research is limited on how daily behaviors of one person in a relationship shape why someone else feels more or less loved from day to day. The parent-adolescent relationship is a primary source of love. We expected parent-reported warmth and conflict would explain daily fluctuations in how loved adolescents reported feeling. In a sample of 151 families (adolescent MAge = 14.60; 61.6% female) over a 21-day period, we used multilevel models to disentangle within-family (daily variability) and between-family (average levels) parent-reported daily warmth and conflict in relation to adolescents' daily reports about how loved they were feeling. Findings indicated adolescents in families with higher parent-reported warmth across days and higher adolescent-reported closeness with parents felt more loved by their parents, on average. At a within-person level, we found considerable day-to-day variability in how loved adolescents reported feeling that was partially explained by meaningful variability in both parent-reported warmth and conflict across days. On days when parents reported more warmth than usual and less conflict than usual, adolescents reported feeling more loved. Further, a significant within-day interaction indicated that the importance of days' parent warmth was greater on high conflict days, but when parents directed more warmth toward their adolescents, the difference between high- and low-conflict days was negligible. Theoretical implications for studying daily emotional love in parent-youth relationships and suggestions for parenting interventions that focus on daily practices of parent warmth are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Adolescent Behavior , Parent-Child Relations , Adolescent , Adolescent Behavior/psychology , Emotions , Female , Humans , Male , Parenting/psychology , Parents/psychology
10.
J Robot Surg ; 16(2): 279-285, 2022 Apr.
Article in English | MEDLINE | ID: mdl-33813713

ABSTRACT

Obesity is an independent risk factor for postoperative morbidity and mortality in laparoscopic colorectal surgery (LCRS). The technological advantages of robotic colorectal surgery (RCRS) may allow surgeons to overcome the limitations of LCRS in obese patients, but it is largely unknown if this translates to superior outcomes. The aim of this study was to compare perioperative, postoperative and short-term oncological outcomes in obese (BMI ≥ 30.0 kg/m2) and non-obese (BMI < 30 kg/m2) patients undergoing RCRS in a university teaching hospital. Demographic, perioperative and postoperative data along with short-term oncological outcomes of obese and non-obese patients that underwent RCRS for both benign and malignant colorectal disease were identified from a prospectively maintained database. A total of 107 patients (34 obese, 73 non-obese) underwent RCRS over a 4-year period. No statistically significant differences in the incidence of complications, 30-day reoperation, 30-day mortality, conversion to open surgery, anastomotic leak or length of inpatient stay were demonstrated. Obese patients had a significantly higher rate of surgical site infection (SSI) (p < 0.0001). Short-term oncological outcomes in both groups were favourable. There was no statistically significant difference in median duration of surgery between the two cohorts. The results demonstrate that obese patients undergoing RCRS in this institution experience similar outcomes to non-obese patients. These results suggest that RCRS is safe and feasible in obese patients and may be superior to LCRS in this cohort, where the literature suggests a higher complication rate compared to non-obese patients. The inherent advantages of robotic surgical platforms, such as improved visualisation, dexterity and ergonomics likely contribute to the improved outcomes in this challenging patient population.


Subject(s)
Colorectal Surgery , Laparoscopy , Robotic Surgical Procedures , Body Mass Index , Colorectal Surgery/methods , Humans , Laparoscopy/methods , Length of Stay , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Retrospective Studies , Robotic Surgical Procedures/methods , Treatment Outcome
11.
Ir J Med Sci ; 191(2): 853-857, 2022 Apr.
Article in English | MEDLINE | ID: mdl-33977392

ABSTRACT

Transanal minimally invasive surgery (TAMIS) has gained worldwide acceptance as a means of local excision of early rectal cancers and benign rectal lesions. However, it is technically challenging due to the limitations of rigid laparoscopic instruments in the narrow rectal lumen. Robotic platforms offer improved ergonomics that are valuable in operative fields with limited space. Robotic TAMIS represents an exciting new development that may be more versatile than traditional TAMIS. In this review, we describe the first case of robotic TAMIS performed in our country and a review of current literature on the technique.


Subject(s)
Rectal Neoplasms , Robotic Surgical Procedures , Transanal Endoscopic Surgery , Humans , Ireland , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Rectum/surgery , Robotic Surgical Procedures/methods , Transanal Endoscopic Surgery/methods
12.
J Robot Surg ; 16(3): 641-647, 2022 Jun.
Article in English | MEDLINE | ID: mdl-34338996

ABSTRACT

The current gold standard surgical treatment for right colonic malignancy is the laparoscopic right hemicolectomy (LRH). However, laparoscopic surgery has limitations which can be overcome by robotic surgery. The benefits of robotics for rectal cancer are widely accepted but its use for right hemicolectomy remains controversial. The aim of this study was to compare outcomes in patients undergoing robotic right hemicolectomy (RRH) and LRH in a university teaching hospital. Demographic, perioperative and postoperative data along with early oncological outcomes of patients who underwent RRH and LRH with extracorporeal anastomosis (ECA) were identified from a prospectively maintained database. A total of 70 patients (35 RRH, 35 LRH) were identified over a 4-year period. No statistically significant differences in estimated blood loss, conversion to open surgery, postoperative complications, anastomotic leak, 30-day reoperation, 30-day mortality, surgical site infection or lengths of stay were demonstrated. Surgical specimen quality in both groups was favourable. The mean duration of surgery was longer in RRH (p < < 0.00001). A statistically significant proportion of RRH patients had a higher BMI and ASA grade. The results demonstrate that RRH is safe and feasible when compared to LRH, with no statistical difference in postoperative morbidity, mortality and early oncological outcomes. A difference was noted in operating time, however was influenced by training residents in docking the robot and a technically challenging cohort of patients. Operative time has shortened with further experience. Incorporating an intracorporeal anastomosis technique in RRH offers the potential to improve outcomes compared to LRH.


Subject(s)
Colonic Neoplasms , Laparoscopy , Robotic Surgical Procedures , Robotics , Anastomosis, Surgical , Colectomy/methods , Colonic Neoplasms/surgery , Humans , Laparoscopy/methods , Length of Stay , Operative Time , Retrospective Studies , Robotic Surgical Procedures/methods
13.
Int J Sex Health ; 34(4): 665-678, 2022.
Article in English | MEDLINE | ID: mdl-36776752

ABSTRACT

Nearly 50% of adults under age 29 report using some form of online dating to find sexual partners or romantic relationships. Limited evidence suggests online and offline dating behaviors and experiences can vary. We aimed to expand understanding these differences by examining how attachment styles are associated with online and offline search for partners and emotional responses to sexual experiences. In a sample of single adults (N = 247; M age= 27.34), we examine how attachment styles relate to individual differences in how people search for partners and respond to sexual experiences with partners met online and offline. Individuals high in attachment anxiety reported higher use of online dating apps and more negative experiences (e.g., lower satisfaction, more guilt) following their most recent sexual encounters with partners met online and offline, and reported feeling more used after engaging in sexual activity specifically with partners met offline. Individuals high in avoidance also reported more negative experiences following their most recent sexual encounters, but only with partners met offline. This study moves our understanding by highlighting nuances in how attachment insecurity is associated with differences in online dating app use and emotions following sexual experiences when meeting partners online and offline.

14.
Exp Appl Acarol ; 85(1): 31-40, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34580809

ABSTRACT

Tritrophic relationships involving tarsonemids and predatory phytoseiids are common in a variety of agroecosystems, but due to the wide range of diets in both families, it is necessary to understand what food resources they are consuming to determine potential impact on crops. We investigated a frequent association of cucurbit powdery mildew (Podosphaera xanthii), Tarsonemus bilobatus, and Proprioseiopsis mexicanus in watermelon and pumpkin fields to determine whether P. mexicanus is consuming either or both of the other organisms. We also examined developmental and reproductive capability of P. mexicanus on these diets. If P. mexicanus is an effective predator of T. bilobatus, it may also be useful in controlling pest tarsonemids, such as broad mites. Proprioseiopsis mexicanus either starved or escaped from arenas rather than consume P. xanthii. When consuming T. bilobatus, P. mexicanus females developed from larva to adult in ca. 3 days. On this diet, the preoviposition period was ca. 2 days and P. mexicanus laid 1.7 eggs/day. These results are comparable to some of the higher-quality non-prey resources investigated in the literature. Starved female P. mexicanus consumed 6.5 T. bilobatus of mixed stages in 1 h. This study provides support for further research into the importance of non-pest tarsonemids as a resource to maintain the presence of generalist predatory mites as an early-intervention natural enemy. Further work should examine the efficacy of P. mexicanus as a natural enemy of economically important pest tarsonemids.


Subject(s)
Erysiphe , Predatory Behavior , Animals , Ascomycota , Crops, Agricultural , Larva
15.
Int J Colorectal Dis ; 36(12): 2585-2598, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34272997

ABSTRACT

BACKGROUND: Non-restorative surgery for rectal cancer is indicated in patients with comorbidities, advanced disease and poor continence. The aim of this meta-analysis was to compare the postoperative morbidity of Hartmann's procedure (HP) with that of extrasphincteric and intersphincteric abdominoperineal resection (APR) in the treatment of rectal cancer. METHODS: The Medline, Embase and Cochrane databases were searched for publications comparing postoperative morbidity of HP and APR. The incidence of overall surgical complications, pelvic-perineal complications and pelvic abscess was analysed as primary endpoints. Readmissions requiring reintervention and postoperative mortality were also compared. RESULTS: A cumulative analysis showed a significantly higher rate of overall complications (odds ratio (OR) 0.553, 95% confidence interval (CI) 0.320 to 0.953 and P value 0.033) and pelvic-perineal complications (OR 0.464, 95% CI 0.250 to 0.861 and P value 0.015) after APR. The incidence of isolated pelvic abscess formation was significantly higher after HP (OR 2.523, 95% CI 1.383 to 4.602 and P value 0.003). A subgroup analysis of intersphincteric APR compared with HP did not show any significant difference in the incidence of overall complications, pelvic-perineal complications or pelvic abscess formation (P values of 0.452, 0.258 and 0.100, respectively). There was no significant difference in readmissions, reinterventions and mortality after HP and APR (P 0.992, 0.198 and 0.151). CONCLUSION: An extrasphincteric APR is associated with higher overall and pelvic-perineal complications and may be reserved for tumours invading the anal sphincter complex. In the absence of sphincter involvement, both HP and intersphincteric APR are better alternatives with comparable morbidity.


Subject(s)
Proctectomy , Rectal Neoplasms , Colostomy , Humans , Postoperative Complications/etiology , Rectal Neoplasms/surgery , Rectum/surgery
16.
Exp Appl Acarol ; 84(1): 121-134, 2021 May.
Article in English | MEDLINE | ID: mdl-33900506

ABSTRACT

The phytoseiid Proprioseiopsis mexicanus has been collected from a wide range of plants in the western hemisphere, including many cucurbit agroecosystems in South Carolina, USA. Our aim was to characterize the lifestyle of P. mexicanus and its potential as a natural enemy of Tetranychus urticae, a common pest in cucurbits. We determined developmental time, pre-oviposition time, and fecundity of females on pollen-only diets from a commercial Typha spp. supplement source, Citrullus lanatus, Cucurbita maxima, Cucurbita moschata, Cucurbita pepo, Delosperma cooperi, Trifolium incarnatum, and on T. urticae and a combination of T. urticae and Typha spp. pollen. Female development time differed based on diet-development was fastest on C. lanatus and D. cooperi diets (ca. 3 days) and slowest on Typha pollen diet (ca. 5 days). Pre-oviposition time was shorter for females fed C. lanatus and T. incarnatum (1.6 days) and longest when fed Typha pollen (3.1 days). Citrullus lanatus, T. incarnatum, and D. cooperi pollen diets resulted in more eggs/day compared to other diets. Cucurbita moschata pollen resulted in the lowest oviposition rate (0.69 eggs/day). Because these pollens varied in size, we examined pollen size as a factor in developmental and reproductive success. With the exception of Typha pollen, small-pollen diets (C. lanatus, D. cooperi, and T. incarnatum) resulted in faster development, shorter pre-oviposition time, and higher fecundity than large-pollen diets (Cucurbita spp.). We concluded that P. mexicanus is a generalist predator that may require pollen for survival and reproduction, but alone this species may not be an effective predator of T. urticae.


Subject(s)
Mites , Tetranychidae , Animals , Female , Fertility , Pest Control, Biological , Predatory Behavior , Reproduction , South Carolina
17.
J Econ Entomol ; 114(2): 818-827, 2021 04 13.
Article in English | MEDLINE | ID: mdl-33503263

ABSTRACT

Twospotted spider mite, Tetranychus urticae Koch (Trombidiformes: Tetranychidae), is an important, worldwide pest of watermelon, Citrullus lanatus L. (Thunb.) Matsum. & Nakai (Cucurbitales: Cucurbitaceae). Feeding results in chlorotic spots and leaf necrosis, which can substantially reduce yields. In watermelon, T. urticae is managed solely with acaricides. Issues with acaricide resistance and pesticide label restrictions on number of applications per season require research-based recommendations on products with effective, long-lasting residues. To improve recommendations for T. urticae management in watermelon and to measure possible effects on non-target beneficial mites, we conducted acaricide efficacy trials in two locations in South Carolina, United States. The adulticidal products abamectin, bifenazate, fenpyroximate, and tolfenpyrad and the ovicidal products spiromesifen and etoxazole were tested. We also conducted two bioassays to better determine duration of acaricide residues. In the field trials, all acaricides except tolfenpyrad reduced T. urticae abundance, but all acaricides also reduced abundance of the most common predatory mite, Neoseiulus fallacis (Garman) (Mesostigmata: Phytoseiidae). In the bioassays, abamectin and bifenazate residues caused high adult T. urticae mortality at up to 21 d after treatment, performing better than fenpyroximate and tolfenpyrad. Etoxazole and spiromesifen were longer lasting, with <1 offspring per treated female in the etoxazole treatment at 28 d after treatment. Based on efficacy, abamectin or bifenazate should be rotated with etoxazole for fast knockdown of active stages while reducing reproduction, respectively. However, development and registration of more selective acaricides in watermelon is needed to preserve biological control of T. urticae by predatory mites.


Subject(s)
Acaricides , Citrullus , Mites , Tetranychidae , Animals , Female , Predatory Behavior , South Carolina
18.
Clin Anat ; 34(1): 82-89, 2021 Jan.
Article in English | MEDLINE | ID: mdl-32648289

ABSTRACT

COVID-19 has generated a global need for technologies that enable communication, collaboration, education and scientific discourse whilst maintaining physical distance. University closures due to COVID-19 and physical distancing measures disrupt academic activities that previously occurred face-to-face. Restrictions placed on universities due to COVID-19 have precluded most conventional forms of education, assessment, research and scientific discourse. Anatomists now require valid, robust and easy-to-use communication tools to facilitate remote teaching, learning and research. Recent advances in communication, video conferencing and digital technologies may facilitate continuity of teaching and research activities. Examples include highly-interactive video conferencing technology, collaborative tools, social media and networking platforms. In this narrative review, we examine the utility of these technologies in supporting effective communication and professional activities of anatomists during COVID-19 and after.


Subject(s)
Anatomy/education , COVID-19 , Communications Media , Education, Distance , Research , Anatomy/methods , Communicable Disease Control , Cooperative Behavior , Education, Medical/methods , Humans , Online Social Networking , Physical Distancing , Social Media , User-Computer Interface , Videoconferencing
19.
J Dig Dis ; 21(6): 355-359, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32410340

ABSTRACT

Fibroblast infiltration and collagen deposition result in structural changes in the bowel wall, and lead to strictures in intestinal inflammatory disease. While strictures can also occur in other contexts, such as malignancy, this review focuses on the surgical treatment of stricture secondary to inflammatory bowel disease. Distinguishing between predominantly inflammation vs established fibrosis as the cause of a stricture can be challenging. While inflammatory strictures may be responsive to medication, predominantly fibrotic strictures usually need surgical intervention. Both endoluminal and extraluminal approaches are described in this review. Endoscopic dilatation of strictures is suitable for short-segment isolated small bowel strictures. Other options are to divide the stricture surgically but preserve the length, performing a strictureplasty or resecting the strictured segment. The mesentery is increasingly recognized as playing a role in stricture recurrence. In a relapsing-remitting disease such as Crohn's disease, the preservation of intestinal length is essential and balance is needed between this and a complete resection to reduce the risk of recurrence. Pre- and postoperative involvement of the multidisciplinary team is essential to improve outcomes in this challenging clinical scenario.


Subject(s)
Constriction, Pathologic/surgery , Dilatation/methods , Endoscopy, Gastrointestinal/methods , Inflammatory Bowel Diseases/surgery , Intestines/pathology , Constriction, Pathologic/etiology , Crohn Disease/complications , Crohn Disease/surgery , Fibrosis/surgery , Humans , Inflammatory Bowel Diseases/complications , Intestines/surgery , Patient Care Team , Recurrence , Treatment Outcome
20.
J Robot Surg ; 14(6): 889-896, 2020 Dec.
Article in English | MEDLINE | ID: mdl-32232680

ABSTRACT

Robotic-assisted surgery is evolving, with improving clinical and cancer outcomes. The aim of this study was to present the clinical and cancer outcomes of patients undergoing robotic-assisted colorectal surgery (RAS-CR) at University Hospital Limerick (UHL) since its introduction to the 100th case, using the daVinci Xi dual-console surgical system. The RAS-CR programme at UHL commenced in June 2016 and the 100th case was performed in July 2019. All patient-related data were recorded prospectively during the perioperative period by the RAS-CR team. Statistical analysis was performed using SPSS, version 22. One hundred patients were operated on, comprising of 47 males and 53 females. The median age was 65 years (IQR 13.0; range 25-84) with 69% of cases performed for cancer [N = 39 rectal cancer, N = 30 colon cancer], 20% for benign disease and 11% for dysplasia. Median length of stay for cancer operations was 6.5 days for colon cancer cases (5.0 days when cases with complications were excluded) and 7.0 days for rectal cancer cases. Median operative time was 255 mins (IQR 130 min; all cases), median docking time was 33 mins (IQR 20 mins) and median intra-operative blood loss was 80 ml (IQR 70 ml). Thirty-one patients developed a post-operative complication (5% anastomotic leak; 13% SSI). In cancer cases, median nodal harvest was 14 nodes (IQR10) and an R0 resection was achieved in 98.6% (n = 68) of cancer cases. Three patients (4.3%) developed metastatic disease at a median interval of 16.5 months. Clinical and operative outcomes remained stable over time from case 1 to 100. Structured introduction of a RAS-CR programme with appropriate governance and continuous audit results in favourable clinical and cancer outcomes and provides an excellent training opportunity for surgical residents.


Subject(s)
Colorectal Neoplasms/surgery , Education, Medical, Graduate/methods , General Surgery/education , Hospitals, Teaching , Robotic Surgical Procedures/education , Robotic Surgical Procedures/instrumentation , Adult , Aged , Aged, 80 and over , Female , Humans , Internship and Residency , Ireland , Male , Middle Aged , Robotic Surgical Procedures/methods , Treatment Outcome
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