Comparison of growth performance and tissue cobalt concentrations in beef cattle fed inorganic and organic cobalt sources.

Cobalt is an essential trace mineral required for ruminal vitamin B12 synthesis, but sources differ in ruminal microbial utilization, i.e., cobalt carbonate is poorly water soluble, whereas acetate and lactate forms are water soluble. Reports comparing organic cobalt lactate to other cobalt salts are lacking. The study objective was to determine if feeding cobalt lactate at two inclusion rates resulted in similar growth performance and tissue cobalt concentrations as the carbonate and acetate forms used in feeds. One hundred Angus cross bred steers weighing 385 ±â€…20 kg were randomly assigned to one of five treatments. Cattle were fed a basal diet plus: 1) cobalt carbonate to supply cobalt at 30 mg/steer/d, 2) cobalt acetate to supply cobalt at 30 mg/steer/d, 3) cobalt acetate to supply cobalt at 60 mg/steer/d, 4) cobalt lactate to supply cobalt at 30 mg/steer/d, and 5) cobalt lactate to supply cobalt at 60 mg/steer/d. Cattle were fed according to industry standards until body fat deposition was visually deemed to grade USDA Choice, which was 92 and 117 d for each of the 2 blocks, respectively. Steers were harvested and carcass measurements recorded along with sampling of adipose, heart, kidney, liver, and muscle for tissue cobalt concentrations. Three statistical contrasts consisted of: 1: inorganic (cobalt carbonate) vs. organic (cobalt acetate and lactate); 2: cobalt acetate vs. cobalt lactate; and 3: feeding rate of 30 vs. 60 mg/steer/d cobalt. Body weight gains, average daily gains, dry matter intake, and feed conversions were similar (P > 0.10) for steers fed all cobalt sources and feeding rates. Hot carcass weight, yield grade, back fat thickness, and ribeye area were similar (P > 0.10) among steers fed all cobalt sources and inclusion rates. Liver, kidney, muscle, and adipose cobalt concentrations were similar (P > 0.08) for steers fed inorganic vs. organic cobalt sources. Feeding cobalt lactate compared with cobalt acetate did not affect (P > 0.10) liver, kidney, heart, muscle, and adipose tissue cobalt concentrations. Feeding 60 mg/steer/d cobalt compared with 30 mg/steer/d increased (P < 0.01) liver, kidney, heart, and adipose tissue cobalt concentrations, while muscle was a tendency (P < 0.06). The study demonstrated that feeding soluble cobalt lactate, a new cobalt source, resulted in similar growth performance, carcass characteristics, and tissue cobalt concentrations when compared with cobalt acetate and carbonate.

Environmental Factors That Affect the Sanitary and Nutritional Variability of Raw Milk in Dual Purpose Livestock Systems of Colombian Orinoquia.

Milk is the natural food with the highest biological quality for the human population and its production can be affected by several sanitary factors and management conditions. With the objective of identifying influence factors on milk compositional and sanitary quality in a region with wide productive potential in the Colombian Orinoquia, an experiment was carried out in two contrasting climatic seasons. For the milk compositional analysis, samples of daily production from 30 dual-purpose systems were analyzed. Similarly, the udder sanitary status of 300 cows was studied using the California Mastitis Test (CMT). Data analysis included mixed models, Pearson correlations, frequency tables, and the Kruskal-Wallis test. The results showed that the total daily milk production of the farm and the season influenced the milk compositional quality. The farms with milk productions lower than 100 kg/day presented the highest levels of protein, lactose, solid non-fat (SNF), and density, while in the rainy season, the milk quality was higher compared to the dry season. The CMT test indicated that only 7.6% of the evaluated mammary quarters presented two or more degrees of positivity. There is an opportunity to improve the milk compositional quality by improving the nutritional offer for animals during the year. The low CMT positivity indicates that, in the calf-at-foot milking system, the presence of subclinical mastitis is not a determining variable in milk production.

Utilization of 5G Technologies in IoT Applications: Current Limitations by Interference and Network Optimization Difficulties-A Review.

5G (fifth-generation technology) technologies are becoming more mainstream thanks to great efforts from telecommunication companies, research facilities, and governments. This technology is often associated with the Internet of Things to improve the quality of life for citizens by automating and gathering data recollection processes. This paper presents the 5G and IoT technologies, explaining common architectures, typical IoT implementations, and recurring problems. This work also presents a detailed and explained overview of interference in general wireless applications, interference unique to 5G and IoT, and possible optimization techniques to overcome these challenges. This manuscript highlights the importance of addressing interference and optimizing network performance in 5G networks to ensure reliable and efficient connectivity for IoT devices, which is essential for adequately functioning business processes. This insight can be helpful for businesses that rely on these technologies to improve their productivity, reduce downtime, and enhance customer satisfaction. We also highlight the potential of the convergence of networks and services in increasing the availability and speed of access to the internet, enabling a range of new and innovative applications and services.

Phylogenetic endemism of the orchids of Megamexico reveals complementary areas for conservation.

Orchid diversity provides a unique opportunity to further our understanding of biotic and abiotic factors linked to patterns of richness, endemism, and phylogenetic endemism in many regions. However, orchid diversity is consistently threatened by illegal trade and habitat transformation. Here, we identified areas critical for orchid conservation in the biogeographic province of Megamexico. For this purpose, we evaluated orchid endemism, phylogenetic diversity, and phylogenetic endemism within Megamexico and characterized orchid life forms. Our results indicate that the majority of the regions with the highest estimates of endemism and phylogenetic endemism are in southern Mexico and northern Central America, mostly located on the Pacific side of Megamexico. Among the most important orchid lineages, several belong to epiphytic lineages such as Pleurothallidinae, Laeliinae and Oncidiinae. We also found that species from diverse and distantly related lineages converge in montane forests where suitable substrates for epiphytes abound. Furthermore, the southernmost areas of phylogenetic diversity and endemism of Megamexico are in unprotected areas. Thus, we conclude that the most critical areas for orchid conservation in Megamexico are located in southern Mexico and northern Central America. We recommend that these areas should be given priority by the Mexican system of natural protected areas as complementary conservation areas.

Tecnoadicción y uso compulsivo de internet en estudiantes universitarios / Technology addiction and compulsive internet use in university

Introducción: uno de los efectos nocivos de las tecnologías de la información y la comunicación (TIC) es su uso sin control, lo que ha generado una adicción hacia ellas. Objetivo: conocer la prevalencia de tecnoadicción de las TIC en estudiantes universitarios de nivel superior, posgrado y profesionistas de diferentes áreas. Metodología: estudio descriptivo cuya población fueron universitarios de nivel superior, posgrado y profesionistas de diferentes áreas de la Universidad Nacional Autónoma de México (UNAM) y del Instituto Politécnico Nacional (IPN) durante el ciclo escolar 2020-2. El muestreo fue no probabilístico. Resultados: al analizar los datos de la Escala de adicción de internet, el 49% respondió que permanece en internet más tiempo del que desea y el 38.2% mencionó que intenta reducir la cantidad de tiempo que pasa en línea. En cuanto al uso compulsivo, el 32.8% mencionó que sigue usando internet a pesar de que su intención es reducir su uso; el 30.5% dice que está corto de sueño debido al uso de internet. Conclusiones: existe tecnoadicción entre profesionistas y estudiantes universitarios de nivel superior y posgrado de la UNAM y del IPN. El personal de salud debe establecer estrategias de prevención del uso del internet para evitar trastornos de salud mental como depresión y aislamiento, entre otros.

Background: One of the harmful effects of the information and communication technologies (ICTs) is their uncontrolled use, which has generated an addiction to them. Objective: To know the prevalence of technology addiction of ICTs in university students of higher level, postgraduate and professionals from different areas. Methodology: Descriptive study whose population was university students of higher level, postgraduate degrees and professionals from different areas of the National Autonomous University of Mexico (UNAM) and the National Polytechnic Institute (IPN) during the 2020-2 school year. The sampling was non-probabilistic. Results: When analyzing the data of the Internet addiction scale, 49% responded that they stay on the internet much more time than what they want to, and 38.2% mentioned that they try to reduce the amount of time they spend online. As for compulsive use, 32.8% mentioned that they continue to use the internet despite the fact that their intention is to use it less; 30.5% say they are short of sleep due to internet use. Conclusions: There is technology addiction among professionals and university students of higher and postgraduate levels of UNAM and IPN. Health personnel must establish prevention strategies for the use of internet, in orded to avoid mental health disorders such as depression, isolation, among others.

Utilization of remote access electron microscopes to enhance technology education and foster STEM interest in preteen students.

Remote access technology in STEM education fills dual roles as an educational tool to deliver science education (Educational Technology) and as a means to teach about technology itself (Technology Education). A five-lesson sequence was introduced to eleven to twelve-year-old students at an urban school. The lesson sequences were inquiry-based, hands-on, and utilized active learning pedagogies which have been implemented in STEM classrooms worldwide. Each lesson employed a Scanning Electron Microscope (SEM) and Energy Dispersive Spectroscopy (EDS) accessed remotely. Students were assessed using multiple choice questions to ascertain (1) technology education learning gains: did students gain an understanding of how electron microscopes work? and (2) educational technology learning gains: did students gain a better understanding of lesson content through use of the electron microscope? Likert-item surveys were developed, distributed and analyzed to established how remote access technology affected student attitudes toward science, college, and technology. Participating students had a positive increase in attitudes toward scientific technology by engaging in the lesson sequences; reported positive attitudes toward remote access experiences; and exhibited learning gains in the science behind the SEM technology they accessed remotely. These findings suggest that remote experiences are a strong form of technology education, but also that future research could explore ways to strengthen remote access as an educational technology (a tool to deliver lesson content), such as one-on-one engagement. This study promotes future research into inquiry-based, hands-on, integrated lessons approach that utilize educational technology learning through remote instruments as a pedagogy to increase students' engagement with and learning of the T in STEM.

Mycobacterium tuberculosis precursor rRNA as a measure of treatment-shortening activity of drugs and regimens.

There is urgent need for new drug regimens that more rapidly cure tuberculosis (TB). Existing TB drugs and regimens vary in treatment-shortening activity, but the molecular basis of these differences is unclear, and no existing assay directly quantifies the ability of a drug or regimen to shorten treatment. Here, we show that drugs historically classified as sterilizing and non-sterilizing have distinct impacts on a fundamental aspect of Mycobacterium tuberculosis physiology: ribosomal RNA (rRNA) synthesis. In culture, in mice, and in human studies, measurement of precursor rRNA reveals that sterilizing drugs and highly effective drug regimens profoundly suppress M. tuberculosis rRNA synthesis, whereas non-sterilizing drugs and weaker regimens do not. The rRNA synthesis ratio provides a readout of drug effect that is orthogonal to traditional measures of bacterial burden. We propose that this metric of drug activity may accelerate the development of shorter TB regimens.

Causas de resistencia al uso de la cofia en alumnas de las licenciaturas de enfermería / Causes of resistance to the use of the cap in students of nursing degrees

Introducción: En su devenir en la historia, la profesión de enfermería ha adoptado y construido símbolos que le representan socialmente. Los más comunes son el uniforme blanco, la capa, la lampara y la cofia. Objetivo: Conocer las causas de resistencia en el uso de la cofia en estudiantes de la licenciatura de enfermería y en enfermería obstétrica. Material y Métodos: Se realizó un estudio descriptivo, la unidad de análisis fueron estudiantes de las licenciaturas en enfermería. La muestra fue de 80 estudiantes del sexo femenino Se aplico un cuestionario, que consta de los siguientes apartados: datos generales y uso y resistencia de la cofia. Resultados: Las estudiantes refieren que el 71% usa la cofia como parte del uniforme, 61% por imposición y solo el 15% la usa como símbolo. El 95% considera que no es útil su uso para el rol de enfermería. El 96% de los estudiantes considera que el uso de la cofia es un factor de riesgo porque puede ser un fomite. Conclusiones: La principal causa de resistencia del uso de la cofia es que no le ven utilidad y la consideran un factor de riesgo para la Infecciones asociadas en la atención a la salud. Sin embargo, no debemos de perder de vista los factores sociohistóricos y las necesidades de cada época y contexto geográfico.

Lower PDL1, PDL2, and AXL Expression on Lung Myeloid Cells Suggests Inflammatory Bias in Smoking and Chronic Obstructive Pulmonary Disease.

Lung myeloid cells are important in pulmonary immune homeostasis and in the pathogenesis of chronic obstructive pulmonary disease (COPD). Multiparameter immunophenotypic characterization of these cells is challenging because of their autofluorescence and diversity. We evaluated the immunophenotypic landscape of airway myeloid cells in COPD using time of flight mass cytometry. Cells from BAL, which were obtained from never-smokers (n = 8) and smokers with (n = 20) and without (n = 4) spirometric COPD, were examined using a 44-parameter time of flight mass cytometry panel. Unsupervised cluster analysis was used to identify cellular subtypes that were confirmed by manual gating. We identified major populations of CD68+ and CD68- cells with 22 distinct phenotypic clusters, of which 18 were myeloid cells. We found a higher abundance of putative recruited myeloid cells (CD68+ classical monocytes) in BAL from patients with COPD. CD68+ classical monocyte population had distinct responses to smoking and COPD that were potentially related to their recruitment from the interstitium and vasculature. We demonstrate that BAL cells from smokers and subjects with COPD have lower AXL expression. Also, among subjects with COPD, we report significant differences in the abundance of PDL1high and PDL2high clusters and in the expression of PDL1 and PDL2 across several macrophage subtypes suggesting modulation of inflammatory responses. In addition, several phenotypic differences in BAL cells from subjects with history of COPD exacerbation were identified that could inform potential disease mechanisms. Overall, we report several changes to the immunophenotypic landscape that occur with smoking, COPD, and past exacerbations that are consistent with decreased regulation and increased activation of inflammatory pathways.

Immune thrombocytopenia secondary to COVID-19: a case report. / Trombocitopenia inmune secundaria a COVID-19: reporte de un caso.

BACKGROUND: The SARS-CoV-2 virus, which emerged in late 2019 in Wuhan province, China, has shown a wide spectrum of manifestations, some of which it shares with some autoimmune disorders. Until now, the association of SARS-CoV-2 with immune thrombocytopenia (ITP) is poorly understood, since the mechanisms that explain the complex relationship between these two prothrombotic states are still unknown. CLINICAL CASE: It is presented the case of a 66-year-old woman, with no chronic disease history, who arrived at the Emergency Department due to respiratory symptoms. It was carried out a polymerase chain reaction with reverse transcriptase, which was positive for SARS-CoV-2. Isolated thrombocytopenia was found in laboratory studies, which was protocolized by ruling out other causes and finally diagnosing ITP secondary to COVID-19. Intravenous steroids treatment was given observing a complete recovery in platelet levels. CONCLUSIONS: Until now, the association of IPT and COVID-19 is unclear and presents challenges in treatment. Steroids continue to be the first choice with the indication to reduce their dose and duration to the minimum necessary. Other second-line treatments present more questions than answers in the context of this pandemic.

INTRODUCCIÓN: el virus del SARS-CoV-2, el cual surgió a finales de 2019 en la provincia de Wuhan, China, ha mostrado un espectro amplio de manifestaciones, algunas de las cuales comparte con algunos trastornos autoinmunes. La asociación del SARS-CoV-2 con la trombocitopenia inmune (TIP) es hasta ahora poco entendida, pues todavía no se conocen los mecanismos que expliquen la compleja relación entre estos dos estados protrombóticos. CASO CLÍNICO: se presenta el caso de una mujer de 66 años, sin antecedentes crónicos, que acudió al Servicio de Urgencias por sintomatología respiratoria. Se realizó prueba de reacción en cadena de la polimerasa con transcriptasa reversa, la cual fue positiva para SARS-CoV-2. En los estudios de laboratorio se encontró trombocitopenia aislada que se protocolizó, por lo que se descartaron otras causas de esta y se diagnosticó TIP secundaria a COVID-19. Se inició tratamiento con esteroides intravenosos y se obtuvo una respuesta completa. CONCLUSIONES: la asociación de TIP y COVID-19 es hasta ahora poco clara y plantea retos en el tratamiento. Los esteroides continúan siendo de primera elección con la indicación de disminuir su dosis y duración a las mínimas necesarias. Otros tratamientos de segunda línea plantean más dudas que respuestas en el contexto de esta pandemia.

CD32-RNA Co-localizes with HIV-RNA in CD3+ Cells Found within Gut Tissues from Viremic and ART-Suppressed Individuals.

BACKGROUND: Identifying biomarkers for cells harboring replication-competent HIV is a major research priority. Recently, there have been mixed reports addressing the possibility that CD32-expressing T cells are enriched for HIV. There is growing evidence that CD32 expression increases with cellular activation that may be related to, but not necessarily specific for, infection with HIV. However, the relationship of CD32 expression to HIV-infection in subtypes of tissue-resident leukocytes is unclear. METHODS: First, we used duplex chromogenic in situ hybridization to identify cells actively transcribing RNA for both CD32 and HIV on human gut tissues. Then we performed multiplexed immunofluorescence and in situ hybridization (mIFISH) on sections from the same tissues to determine the phenotype of individual cells co-expressing HIV-RNA and CD32-RNA. RESULTS: HIV-RNA+ cells were more abundant in tissues from viremic individuals than in those receiving suppressive anti-retroviral therapy (ART). However, staining by both methods indicated that a higher proportion of HIV-RNA+ cells co-expressed CD32-RNA in ART-suppressed individuals than in those with viremia. The majority of HIV-RNA+ cells were CD3+. CONCLUSIONS: Our data suggest that the transcription of CD32-RNA is correlated with HIV transcriptional activity in CD3+ cells found within human gut tissue. Whether or not up-regulation of CD32-RNA is a direct result of HIV transcription or more global T-cell activation remains unclear.

Making it RAIN: Using Remotely Accessible Instruments in Nanotechnology to Enhance High School Science Courses.

The Remotely Accessible Instruments in Nanotechnology (RAIN) Network is a conglomerate of nineteen community colleges, four-year universities and high school sites that aims to enhance STEM learning by bringing advanced technologies to K-12 education. RAIN provides free remote access to instruments such as Scanning Electron, Atomic Force and Transmission Electron Microscopes, as well as Energy Dispersive and Infrared Spectroscopy. The following is a variety of experiments and an empirical formula lab that can be performed in a high school physical science or chemistry classroom that utilizes the RAIN Network.

Light up My Life: An Active Learning Lab to Elucidate Conductive Properties of Electrolytes.

Understanding molecular structure and its influence on chemical reactivity is a fundamental component in Chemistry curriculum. For example, acidic protons ionize, or ionic solids dissociate to form charge, inducing electrolyte properties depending on molecular structure. An active learning lab is designed to demonstrate connection between electrolyte behavior and structure of various molecules. Experiments are shared to show interdisciplinary aspect of electrolytes within biology and chemistry. Specifically, how biomolecules exhibit electrolyte behavior due to chemical composition.

Increased HIV-1 transcriptional activity and infectious burden in peripheral blood and gut-associated CD4+ T cells expressing CD30.

HIV-1-infected cells persist indefinitely despite the use of combination antiretroviral therapy (ART), and novel therapeutic strategies to target and purge residual infected cells in individuals on ART are urgently needed. Here, we demonstrate that CD4+ T cell-associated HIV-1 RNA is often highly enriched in cells expressing CD30, and that cells expressing this marker considerably contribute to the total pool of transcriptionally active CD4+ lymphocytes in individuals on suppressive ART. Using in situ RNA hybridization studies, we show co-localization of CD30 with HIV-1 transcriptional activity in gut-associated lymphoid tissues. We also demonstrate that ex vivo treatment with brentuximab vedotin, an antibody-drug conjugate (ADC) that targets CD30, significantly reduces the total amount of HIV-1 DNA in peripheral blood mononuclear cells obtained from infected, ART-suppressed individuals. Finally, we observed that an HIV-1-infected individual, who received repeated brentuximab vedotin infusions for lymphoma, had no detectable virus in peripheral blood mononuclear cells. Overall, CD30 may be a marker of residual, transcriptionally active HIV-1 infected cells in the setting of suppressive ART. Given that CD30 is only expressed on a small number of total mononuclear cells, it is a potential therapeutic target of persistent HIV-1 infection.

Elucidating the Burden of HIV in Tissues Using Multiplexed Immunofluorescence and In Situ Hybridization: Methods for the Single-Cell Phenotypic Characterization of Cells Harboring HIV In Situ.

Persistent tissue reservoirs of HIV present a major barrier to cure. Defining subsets of infected cells in tissues is a major focus of HIV cure research. Herein, we describe a novel multiplexed in situ hybridization (ISH) (RNAscope) protocol to detect HIV-DNA (vDNA) and HIV-RNA (vRNA) in formalin-fixed paraffin-embedded (FFPE) human tissues in combination with immunofluorescence (IF) phenotyping of the infected cells. We show that multiplexed IF and ISH (mIFISH) is suitable for quantitative assessment of HIV vRNA and vDNA and that multiparameter IF phenotyping allows precise identification of the cellular source of the ISH signal. We also provide semi-quantitative data on the impact of various tissue fixatives on the detectability of vDNA and vRNA with RNAscope technology. Finally, we describe methods to quantitate the ISH signal on whole-slide digital images and validation of the quantitative ISH data with quantitative real-time PCR for vRNA. It is our hope that this approach will provide insight into the biology of HIV tissue reservoirs and to inform strategies aimed at curing HIV.

Cultivating Mars: A Project-Based Learning Lab Analyzing an Oxygen Based Redox Reaction in Order to Design an Oxygen-Rich Environment on the Red Planet.

In a series of activities/labs, designed in a building block approach, whereas each subsequent lab builds into the next, students will explore the reactivity and production of oxygen in various biological and chemical systems. Through student-constructed analyses, participants will optimize oxygen-generating systems for the colonization of Mars, wherein their system will be used as part of a narrative to construct a livable habitat for future astronauts. Use of remote access technology to a Scanning Electron Microscope (SEM) with elemental analysis capabilities allows students to investigate their oxygen reaction via formation of iron oxide, resulting in rich multidimensional and contextualized scientific exploration in the chemistry classroom.

CONTEXTUALIZING TECHNOLOGY IN THE CLASSROOM VIA REMOTE ACCESS: USING SPACE EXPLORATION THEMES AND SCANNING ELECTRON MICROSCOPY AS TOOLS TO PROMOTE ENGAGEMENT IN GEOLOGY/CHEMISTRY EXPERIMENTS.

A multidisciplinary science experiment was performed in K-12 classrooms focusing on the interconnection between technology with geology and chemistry. The engagement and passion for science of over eight hundred students across twenty-one classrooms, utilizing a combination of hands-on activities using relationships between Earth and space rock studies, followed by a remote access session wherein students remotely employed the use of a scanning electron microscope (SEM) and energy-dispersive spectroscopy (EDS) to validate their findings was investigated. Participants represent predominantly low-income minority communities, with little exposure to the themes and equipment used, despite being freely available resources. Students indicated greatly increased interest in scientific practices and careers, as well as a better grasp of the content as a result of the lab and remote access coupling format.

Mass Cytometric Analysis of HIV Entry, Replication, and Remodeling in Tissue CD4+ T Cells.

To characterize susceptibility to HIV infection, we phenotyped infected tonsillar T cells by single-cell mass cytometry and created comprehensive maps to identify which subsets of CD4+ T cells support HIV fusion and productive infection. By comparing HIV-fused and HIV-infected cells through dimensionality reduction, clustering, and statistical approaches to account for viral perturbations, we identified a subset of memory CD4+ T cells that support HIV entry but not viral gene expression. These cells express high levels of CD127, the IL-7 receptor, and are believed to be long-lived lymphocytes. In HIV-infected patients, CD127-expressing cells preferentially localize to extrafollicular lymphoid regions with limited viral replication. Thus, CyTOF-based phenotyping, combined with analytical approaches to distinguish between selective infection and receptor modulation by viruses, can be used as a discovery tool.

Building operative care capacity in a resource limited setting: The Mongolian model of the expansion of sustainable laparoscopic cholecystectomy.

BACKGROUND: The benefits of laparoscopic cholecystectomy, including rapid recovery and fewer infections, have been largely unavailable to the majority of people in developing countries. Compared to other countries, Mongolia has an extremely high incidence of gallbladder disease. In 2005, only 2% of cholecystectomies were performed laparoscopically. This is a retrospective review of the transition from open to laparoscopic cholecystectomy throughout Mongolia. METHODS: A cross-sectional, retrospective review was conducted of demographic patient data, diagnosis type, and operation performed (laparoscopic versus open cholecystectomy) from 2005-2013. Trends were analyzed from 6 of the 21 provinces (aimags) throughout Mongolia, and data were culled from 7 regional diagnostic referral and treatment centers and 2 tertiary academic medical centers. The data were analyzed by individual training center and by year before being compared between rural and urban centers. RESULTS: We analyzed and compared 14,522 cholecystectomies (n = 4,086 [28%] men, n = 10,436 [72%] women). Men and women were similar in age (men 52.2, standard deviation 14.8; women 49.4, standard deviation 15.7) and in the percentage undergoing laparoscopic cholecystectomy (men 39%, women 42%). By 2013, 58% of gallbladders were removed laparoscopically countrywide compared with only 2% in 2005. In 2011, laparoscopic cholecystectomy surpassed open cholecystectomy as the primary method for gallbladder removal countrywide. More than 315 Mongolian health care practitioners received laparoscopic training in 19 of the country's 21 aimags (states). CONCLUSION: By 2013, 58% of cholecystectomies countrywide were performed laparoscopically, a dramatic increase over 9 years. The expansion of laparoscopic cholecystectomy has transformed the care of biliary tract disease in Mongolia despite the country's limited resources.