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Teaching Methodology for the Training of a laparoscopic Technique: Intestinal Anastomosis

Surgical Science 2017年第8期8卷 384-401页

作者： josé luis Ruiz-Gómez Roberto Fernández Santiago antonio lópez Useros Carlos Redondo-Figuero josé C. Manuel-Palazuelos Instructor General Surgery Hospital Virtual Valdecilla Santander Spain Medical and Chirurgical Science University of Cantabria Santander Spain Hospital Virtual Valdecilla Santander Spain

Traditionally surgeons learned surgical techniques by training them directly in the patient by imitating the actions of the surgeon with more experience. Today this methodology is difficult to apply, since there are multiple factors that hinder its use. The limited time of training systems, scarcity of resources, patient safety or the need to learn new techniques of minimally invasive surgery, make the training of surgeons require a different learning methodology. This study has designed a new methodology for the learning of surgical techniques that minimizes the impact of all the previous factors on the training of surgeons. Its effectiveness in the teaching of laparoscopic manual intestinal anastomosis is analyzed. It has been asked a group of 24 expert surgeons teaching in intestinal anastomoses, which are the steps that must include the teaching of the technique. The phases evaluated with the highest score were included in the methodology. Once the steps of the methodology were designed, 25 general surgeons were chosen and divided into three groups according to their level of experience (experts, trained and beginners). Each participant performed five training sessions following the new methodology. The technical quality of the anastomosis, the overall development of the operation, as well as the feedback developed between the participants and the instructor was analyzed. After analyzing the results it was observed that structured feedback between the instructor and the participant increases the involvement of the participant in the learning process and reduces the time needed to acquire the competence. With this methodology the inexperienced participants perform the fifth anastomosis with quality parameters close to those obtained by the expert participants. In addition, this methodology allows to individualize the learning according to the needs of each participant.

关键词： Methodology learn Surgery Anastomosis Intestinal

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Gastric necrosis: A late complication of nissen fundoplication

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World Journal of Gastrointestinal Surgery 2014年第9期6卷 183-186页

作者： Javier Salinas Tihomir Georgiev Juan antonio González-Sánchez Elena lópez-Ruiz josé antonio Rodríguez-Montes Department of General Surgery Hospital Universitario La Paz Department of Pathology Hospital Universi-tario La Paz

Gastric necrosis is a rare condition because of the rich blood supply and the extensive submucosal vascular network of the stomach. "Gas-bloat" syndrome is a well known Nissen fundoplication postoperative complica-tion. It may cause severe gastric dilatation, but very rarely an ischemic compromise of the organ. Other factors, such as gastric outlet obstruction, may concur to cause an intraluminal pressure enough to blockade venous return and ultimately arterial blood supply and oxygen deliver, leading to ischaemia. We report a case of a 63-year-old women, who presented a total gastric necrosis following laparoscopic Nissen fundoplication and a pyloric phytobezoar which was the trigger event. No preexisting gastric motility disorders were present by the time of surgery, as demonstrated in the preop-erative barium swallow, thus a poor mastication(patient needed no dentures) of a high fiber meal(cabbage) may have been predisposing factors for the develop-ment of a bezoar in an otherwise healthy women at the onset of old age. A total gastrectomy with esophagojejunostomy was performed and patient was discharged home after a 7-d hospital stay with no immediate com-plications. We also discuss some technical aspects of the procedure that might be important to reduce the incidence of this complication.

关键词： Gastric dilatation Gastric outlet obstruction Necrosis Fundoplication Nissen operation

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Strategies for the Extraction, Purification and Amplification of Metagenomic DNA from Soil Growing Sugarcane

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Advances in Biological Chemistry 2014年第4期4卷 281-289页

作者： luis Raúl Gutiérrez-lucas Juan josé Montor-antonio Nohemí Gabriela Cortés-lópez Sandra del Moral División de Estudios de Posgrado Universidad del Papaloapan Tuxtepec México Instituto de Biotecnología. Universidad del Papaloapan Tuxtepec Oaxaca México

Recently, studies were initiated to investigate the metagenome, which represents the genomes of cultured and uncultured microbes, as a rich source for isolation of many novel genes. The meta-genomic approach originated from the molecular analysis of microbial communities, which revealed that the majority of microorganisms in nature were not cultivable by standard culturing techniques. Therefore, most microorganisms in nature have not been characterized. Although numerous methods have been reported for direct DNA isolation and purification from microorganisms in soil, the sample preparation procedures and experimental conditions used in different studies vary widely. Soils are therefore one of the most challenging environmental matrices from which to obtain microbial DNA that will support PCR. The Papaloapan River is the second largest river basin in México. For the climatic conditions of this region, there is great diversity in plants, animals and microorganisms. In the Papaloapan region different fruits are grown, however, the main crops are sugarcane and pineapple. In this work the extraction of DNA from soils of sugarcane cultivation was performed. We used PCR tests to assess the quality of DNA extracted from soil by amplifying the 16S rDNA gene. Changes in both protocols were performed;satisfactory results were obtained as to the quality of DNA and gene amplification. These results will allow continuing the metagenomic studies, such as sequencing, library construction and identification of enzymes cellulase and amylase activity. It is the first time these studies were performed in the Papaloapan region.

关键词： Metagenomic Soil DNA Metagenome Papaloapan Basin

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Internet of things:Conceptual network structure,main challenges and future directions

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Digital Communications and Networks 2023年第3期9卷 677-687页

作者： leonardo B.Furstenau Yan Pablo Reckziegel Rodrigues Michele Kremer Sott Pedro leivas Michael S.Dohan josé Ricardo lópez-Robles Manuel J.Cobo Nicola luigi Bragazzi Kim-Kwang Raymond Choo Department of Industrial Engineering Federal University of Rio Grande do SulPorto Alegre 90035-190Brazil University of Santa Cruz do Sul Av.Independencia2293Santa Cruz do SulRSBrazil Business School Unisinos UniversityAv.Dr.Nilo Peçanha 160091330-002Porto AlegreBrazil lakehead University Thunder BayONP7B 5E1Canada Academic Unit of Accounting and Management Autonomous University of ZacatecasCalle Comercio y Administracion S/NFracc.ProgresoC.P.98066ZacatecasZacatecasMexico Department of Computer Science and Artificial Intelligence University of Granada18071 GranadaSpain York University ONM3J 1P3Canada Department of Information Systems and Cyber Security University of Texas at San AntonioSan AntonioTX78249USA

Internet of Things(IoT)is a key technology trend that supports our digitalized society in applications such as smart countries and smart *** this study,we investigate the existing strategic themes,thematic evolution structure,key challenges,and potential research opportunities associated with the *** this study,we conduct a Bibliometric Performance and Network Analysis(BPNA),supplemented by an exhaustive Systematic literature Review(SlR).Specifically,in BPNA,the software SciMAT is used to analyze 14,385 documents and 30,381 keywords in the Web of Science(WoS)database,which was released between 2002 and *** results reveal that 31 clusters are classified according to their importance and development,and the conceptual structures of key clusters are presented,along with their performance analysis and the relationship with other *** thematic evolution structure describes the important cluster(s)over *** the SlR,23 documents are *** SlR reveals key challenges and limitations associated with the *** expect the results will form the basis of future research and guide decision-making in the IoT and other supporting industries.

关键词： Internet of things Strategic intelligence Industry 4.0 SciMAT Bibliometric analysis Science mapping

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High-resolution patterns of palaeoenvironmental changes during the little Ice Age and the Medieval Climate Anomaly in the northwestern Iberian Peninsula

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Geoscience Frontiers 2020年第5期11卷 1461-1475页

作者： Daniel Castro Martin Souto Maria Isabel Fraga Eduardo Garcia-Rodeja Sebastian Perez-Diaz jose antonio lopez Saez Xabier Pontevedra-Pombal Dpto.Botanica Fac.BioloxiaUniversidade de Santiago de CompostelaGaliciaSpain Dpto.Edafoloxia e Quimica Agricola Fac.BioloxiaUniversidade de Santiago de CompostelaGaliciaSpain Dpto.Geografia Urbanismo y Ordenacion Del TerritorioETS CaminosCanales y PuertosUniversidad de CantabriaSpain GI Arqueobiologia Instituto de HistoriaCCHS–CSICMadridSpain

to identify plant macrofossils,estimate peat humification and calculate hydroclimatic indices based on current bog species,with the overall aim of determining the climate conditions associated with evolution of the bog during the Medieval Climate Anomaly and the little Ice *** proxies,together with historical and climate data,proved to be good indicators of the changes in bog surface ***:of the core led to identification of 9 different periods:two corresponding to the so-called Medieval Climate Anomaly(930 to 1345 AD,1075–665 calibrated years before present[*** BP]);four corresponding to the little Ice Age(1345 to 1905 AD;665–105 cal yr BP);and three corresponding to the last century(1905 to 2000 AD).The findings revealed a generally dry climate that lasted until the 14th century,followed by a transition to a long period with a more humid,but characteristically very variable climate,which ended at the beginning of the 20th century and was followed by a rapid transition to more humid conditions and finally,a change to drier *** Medieval Climate Anomaly was indicated by the abundance of dry-adapted mosses(leucobryum glaucum,Hypnum cupressiforme)and characterized by warm dry conditions and high levels of peat humification,with alternating wet *** lIA period was dated by a large abundance of Sphagnum species(an indicator of wetness)and a gradual increase in the humification ***,four different climate phases were differentiated in this ***-resolution reconstruction of the evolution of the CVM bog and the multiproxy approach have together enabled a more detailed identification of climatic variations in this area,which are generally consistent with the global models,as well as better definition of the elusive climatic oscillations in the last millennium and confirmation of the importance of local modulation of global *** study provides new information and a detailed chronology of climatic events that will hel

关键词： last millennium Raised bog Plant macrofossil Humification analysis Southwest Europe Climate change

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Association of COl1A1 rs180012 SNP and Fibromyalgia Suggests the Implication of Collagen Structure in Musculoskeletal Pain

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Advances in Bioscience and Biotechnology 2018年第2期9卷 83-89页

作者： Isabel Navarro-Vera josé antonio Casajús Manuel J. lópez-Pérez Carmen Díez-Sánchez Departamento de Bioquímica Biología Molecular y Celular Universidad de Zaragoza Zaragoza Spain Departamento de Genética Molecular Citogen Zaragoza Spain Departmento de Fisiatría y Enfermería Facultad de Ciencias de la Salud y el Deporte Universidad de Zaragoza. Zaragoza Spain Departamento de Bioquímica Biología Molecular y Celular—Centro de Investigaciones Biomédicas en Red de Enfermedades Raras (CIBERER)—Instituto de Investigación Sanitaria de Aragón (IISA) Zaragoza Spain

Fibromyalgia (FM) is a complex, chronic condition, which causes widespread musculoskeletal pain, fatigue and a variety of other symptoms. Many polymorphisms related to neuroendocrine system function as the ApoE isoforms, Val158Met polymorphism in COMT, as well as a 44 bp deletion located in 5-HTTlPR, have been studied. Other polymorphisms have been related to inflammatory response such as the 70 bp VNTR in Il-4 or to citokine levels. Furthermore, some studies focused on finding out new FM related SNPs, have been performed by genome wide association scan (GWAS). The target of this work was to study a possible linkage of a collagen type I polymorphism (COl1A1 rs180012 SNP) affecting bone mineralization, with fibromyalgia. Results obtained show a clear association of ss homozygous genotype with FM patients no dependent on bone mineralization.

关键词： Fibromyalgia Genotype Collagen Bone Mineral Density SP1

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Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

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Journal of Geriatric Cardiology 2021年第1期18卷 20-29页

作者： Juan Martínez-Milla Marcelino Cortés García Julia Anna Palfy Mikel Taibo Urquía Marta lópez Castillo Ana Devesa Arbiol Ana lucía Rivero Monteagudo María luisa Martín Mariscal Inés Jiménez-Varas Sem Briongos Figuero Juan antonio Franco-Pelaéz joséTuñón Department of Cardiology Hospital Universitario Fundación Jiménez Díaz-Quirónsalud Centro Nacional de Investigaciones Cardiovasculares MadridSpain Department of Cardiology Hospital Central de Asturias Department of Cardiology Hospital Universitario Ruber-Quirónsalud Department of Cardiology Hospital Universitario Infanta Leonor Department of Endocrinology Hospital Clínico San Carlos Universidad Autónoma de Madrid CIBERCV MadridSpain

OBJECTIVE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged≥75 *** AND RESUlTS From January 2008 to July 2014,we included 390 consecutive patients≥75 years of age with ejection fraction≤35%and glomerular filtration rate(GFR)≤60 m l/min per 1.73 m^*** analyzed the relationship between treatment with BB and mortality or cardiovascular *** mean age of our population was 82.6±4.1 *** ejection fraction was 27.9%±6.5%.GFR was 60-45 m l/min per 1.73 m^2 in 50.3%of patients,45-30 m l/min per 1.73 m^2 in 37.4%,andl/min per 1.73 m^2 in 12.3%.At the conclusion of follow-up,67.4%of patients were receiving *** median follow-up was28.04(IR:19.41-36.67)*** the study period,211 patients(54.1%)died and 257(65.9%)had a major cardiovascular event(death or hospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95%CI:0.35-0.74;Ply showed a reduced risk of death across the different stages of CKD:stage IIIa(GFR=30-45 m l/min per 1.73 m^2;HR=0.47,95%CI:0.26-0.86,Pl/min per 1.73 m^2;HR=0.55,95%CI:0.26-1.06,P=0.007),and stages IV and V(GFRl/min per 1.73 m~2;HR=0.29,95%CI:0.11-0.76;P=0.047).CONClUSIONS The use of BB in elderly patients with HFr EF and renal impairment was associated with a better *** of BB should be encouraged when possible.

关键词： CKD GFR Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

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Use of subcutaneous tocilizumab to prepare intravenous solutions for COVID-19 emergency shortage:Comparative analytical study of physicochemical quality attributes

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Journal of Pharmaceutical Analysis 2020年第6期10卷 532-545页

作者： Natalia Navas Jesús Hermosilla Anabel Torrente-lopez jose Hernandez-Jimenez jose Cabeza Raquel Perez-Roblesa antonio Salmeron-García Department of Analytical Chemistry Science Faculty/Biomedical Research Institute ibs.GranadaUniversity of GranadaGranadaE-18071Spain UGC Farmacia Hospitalaria Biomedical Research Institute ibs.Granada.Hospital Universitario San Cecilio de GranadaGranadaE-18012Spain

COVID-19,a disease caused by the novel coronavirus SARS-Co V-2,has produced a serious emergency for global public health,placing enormous stress on national health systems in many *** studies suggest that cytokine storms(interleukins)may play an important role in severe cases of *** key inflammatory factors in cytokine release syndrome(CRS)could therefore be of great value in reducing the mortality ***(TCZ)in its intravenous(IV)form of administration-Ro Actemra?20 mg/m l(Roche)-is indicated for treatment of severe CRS *** investigations have concluded that inhibition of Il-6 with TCZ appears to be efficacious and safe,with several ongoing clinical *** has led to a huge increase in demand for IV TCZ for treating severe COVID-19 patients in hospitals,which has resulted in drug ***,we present a comparability study assessing the main critical physicochemical attributes of TCZ solutions used for infusion,at 6 mg/m l and 4 mg/m l,prepared from Ro Actemra?20 mg/m l(IV form)and from Ro Actemra?162 mg(0.9 m l solution pre-filled syringe,subcutaneous(SC)form),to evaluate the use of the latter for preparing clinical solutions required for IV administration,so that in a situation of shortage of the IV medicine,the SC form could be used to prepare the solutions for IV delivery of *** is important to remember that during the current pandemic all the medicines are used off-label,since none of them has yet been approved for the treatment of COVID-19.

关键词： COVID-19 Tocilizumab Critical quality attributes IV and SC medicines

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Physico-Chemical Characteristics of the Products Derived from the Thermolysis of Waste AbiesalbaMill. Wood

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Journal of Environmental Protection 2013年第1期4卷 26-30页

作者： Félix antonio lópez Olga Rodríguez Andrea Urien Belén lobato Teresa álvarez Centeno Francisco josé Alguacil Centro Nacional de Investigaciones Metalúrgicas Consejo Superior de Investigaciones Científicas Madrid Spain Instituto Nacional del Carbón Consejo Superior de Investigaciones Científicas Oviedo Spain

This paper reports the physico-chemical characteristics of the products derived from the thermolysis (thermolytic distillation) of waste silver fir (Abies alba Mill.) wood at different temperatures (400℃- 600℃) in a pilot scale plant. Depending on the thermolysis temperature, the procedure yielded 45 - 53 wt% pyroligneous acid with a high water content (80 - 86 wt%) and pH ≈ 3.6. The process also produced a carbonaceous solid or biochar (23 - 26 wt%), its properties strongly dependent on the thermolysis temperature. Gases (20 - 31 wt%) were also produced;these were transformed into electrical energy via a gas turbine. The pyroligneous acid was centrifuged to isolate a subfraction composed mostly of phenols (phenol, mequinol and furfural) with a total C content of 68 - 74 wt%. The remainder was subjected to fractionated distillation at laboratory scale, and the distillate subjected to liquid-liquid extraction using diethyl ether in two stages to obtain a bio-oil composed mainly of acetic acid (≈47%), aldehydes, ketones and alcohols (≈31%), phe- nols (≈18%) and aliphatic alcohols. The characteristics of the bio-oil depended on the thermolysis temperature.

关键词： Thrermolysis Abies alba Mill. Bio-Oil Biochar

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Variation of Density and Biomass of the Ichthyofauna Associated to Soft Bottoms of a Western Coastal lagoon of B.C.S., Mexico

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Open Journal of Marine Science 2021年第4期11卷 169-186页

作者： Bruma Rachel Castillo Rosas Emelio Barjau González Juan Manuel lópez Vivas josé Ángel Armenta Quintana Javier Aguilar Parra Rodolfo Daniel Acosta guerrero Rogelio Esquivel Tiscareño Departamento Académico de Ciencias Marinas y Costeras Universidad Autónoma de Baja California Sur La Paz B.C.S. Departamento Académico de Ciencia Animal y Conservación del Hábitat Universidad Autónoma de Baja California Sur La Paz B.C.S. Departamento Académico de Sistemas Computacionales Universidad Autónoma de Baja California Sur La Paz B.C.S.

An analysis of the variation of the density and biomass of the fish communities of the lagoon of la Paz, Mexico was carried out from November 2016 to September 2017. A total of 2763 organisms were collected with a total biomass of 211,422.93 g in an area of 5022 m2, a density and biomass of 0.550 lnd/m2 and 44.091 g/m2. The site with the largest biomass was recorded in Zacatecas (11.179 g/m2) located north of the lagoon, while Grand Plaza recorded the lowest biomass (2.732 g/m2). Regarding the density, the maximum value was recorded in the site Yate Hundido, located northwest of the lagoon (0.129 lnd/m2) and the lowest was las Palmas (0.036 lnd/m2) located north of the lagoon. The most abundant species was Diapterus peruvianus with 683 individuals and a biomass of 37,507.57 g. The physicochemical variables showed two seasons with significant change where we can observe higher temperatures in the summer (average of 27.45°C) and minimum in winter (average of 22.49°C). The Shannon-Weaver diversity index showed a difference (p = 0.050) between months, with the highest value recorded in April (H' = 2.133 bits/ind) and the lowest in June (H'le="white-space:normal;">le="font-family:;" "=""> = 1.041 bits/ind). The biomass and density values recorded in the lagoon were found to be associated with the spatio-temporal variation of temperature of the lagoon, as well as the resident and transitory species located in the area of study. In addition

关键词： lagoon of la Paz Diversity Abundance Dominance

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