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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： jos. Luis ruiz-Gómez Roberto Fernández Santiago Antonio López Useros Carlos Redondo-Figuero jos. 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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Assessment of the Acoustic Impact of Wind Farm Projects: Methodology and Case

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Journal of Geoscience and Environment Protection 2018年第1期6卷 99-110页

作者： jos. Molina-ruiz Mari Luz García-Lorenzo María jos. Martínez-Sánchez Diego Gallego Department of Geography Faculty of Geography University of Murcia Murcia Spain Department of Mineralogy and Petrology Faculty of Geology University Complutense of Madrid Madrid Spain Department of Agricultural Chemistry Geology and Pedology Faculty of Chemistry University of Murcia Murcia Spain Diego Gallego Cambronero Departamento Ecologia Faculty of Sciences University of Alicante Alicante Spain

Wind energy is a clean renewable and its benefits are considered greater than the disadvantages. However, even though wind farms represent environmentally friendly projects, they frequently generate public resistance. Wind turbines are socially controversial because of their visual and acoustic impacts. The aim of this work was to design a methodology for the preliminary evaluation of potential acoustic impact of wind farms. Three steps have been proposed: identification, characterization and assessment of the acoustic impact during the construction, operation and decommissioning phase. Obtained results in the studied area suggested that at a maximum power, at 500 meters of wind turbines, noise level is lower than the reference level established in the legislation. In summary, proposed methodology could help to determine and to evaluate the best location for new wind farm projects. Proposed methodology could help to determine and to evaluate the best location for new wind farm projects. Moreover, this method could be used as a consulting tool for public organizations and private institutions, being quick, concise and clear. Obtained results for the studied wind farm project suggested that almost all the area showed noise levels lower than established background noise level.

关键词： Wind Turbine Environmental Impact Assessment Acoustic Impact Wind Farm

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玻璃体腔内注射Bevacizumab联合白内障手术治疗湿性年龄相关性黄斑变性(英文)

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国际眼科杂志 2010年第7期10卷 1245-1247页

作者： jos. M ruiz-Moreno Javier A Montero Pedro Amat-Pera Francisco L Lugo 两班牙Castilla La Mancha大学阿利坎特医学院眼科西班牙阿利坎特眼科研究所视网膜科两班牙Valladolid Pio del Rio Hortega大学附属医院眼科组

目的:探讨玻璃体腔内注射bevacizumab (Avastin)联合白内障手术预防脉络膜新生血管(choroidal neovascularization,CNV)的再次激活及年龄相关性黄斑变性(age-relatedmacular degeneration, AMD)。方法:对12例接受湿性年龄相关变性治疗的白内障患者给予透明角膜切口白内障超声乳化和人工晶状体植入手术,最后予以玻璃体腔内注射1.25mg bevacizumab (0.05mL)。主要评价指标:视力恢复、脉络膜新生血管的再次激活,及相干光断层成相术(OCT)对渗漏液体的评估。结果:患者最佳矫正视力(best-corrected visual acuity, BCVA)术后显著提高(脉络膜新生血管闭合后P<0.01,白内障发生后P=0.049,t检验)。白内障术后平均随访时间为11.8mo(标准差6.1,范围3 ～22mo),随访期内患者未出现脉络膜新生血管的再次激活及新的脉络膜新生血管病变。结论:在给予脉络膜新生血管及年龄相关性黄斑变性治疗的患者,白内障手术联合玻璃体腔内注射bevacizumab可预防脉络膜新生血管的再次激活。

关键词：年龄相关性黄斑变性 bevacizmnab 白内障手术脉络膜新生血管

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Pharmacological strategies in extracorporeal membrane oxygenation weaning failure: a call to action

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Emergency and Critical Care Medicine 2023年第2期3卷 43-45页

作者： Francisco J.González-ruiz Francisco M.Baranda-Tovar Luis A.Baeza-Herrera jos.D.Utrilla-Álvarez Ricardo E.Quirázco-Cordova Gustavo Rojas-Velasco Department of Cardiovascular Critical Care National Institute of Cardiology“Dr.Ignacio Chávez”Mexico CityMexico National Institute of Cardiology.Juan Badiano 1 Belisario Dominguez Secc 16Tlalpan14080Mexico CityMexico

Extracorporeal membrane oxygenation has emerged as a viable alternative for stabilizing and improving critically ill patients in acute cardiovascular ***,the weaning stage has been associated with a high morbidity and mortality *** makes searching for strategies that reduce failure in this final process *** a new approach must be tried and included in our protocols,seeking the patient’s well-being at all *** this article,the authors discuss their point of view regarding potential pharmacological alternatives and the mechanism of action involved,which could decrease the mortality associated with this therapeutic.

关键词： β-Blockers Extracorporeal membrane oxygenation Inodilators Mechanical circulatory support Pharmacological strategies

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Serum levels of the novel adipokine isthmin-1 are associated with obesity in pubertal boys

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World Journal of Pediatrics 2023年第9期19卷 864-872页

作者： Francisco Javier ruiz‑Ojeda Augusto Anguita‑ruiz Maria C.Rico Rosaura Leis Gloria Bueno Luis A.Moreno Mercedes Gil‑Campos Ángel Gil Concepción M.Aguilera Department of Biochemistry and Molecular Biology Ⅱ School of PharmacyUniversity of GranadaGranadaSpain Instituto de Investigación Biosanitaria Ibs.GRANADA 18012 GranadaSpain Institute of Nutrition and Food Technology“jos.Mataix” Center of Biomedical ResearchUniversity of GranadaAvda.del Conocimiento S/N.18016 ArmillaGranadaSpain RG Adipocytes and Metabolism Institute for Diabetes and ObesityHelmholtz Center Munich85764 MunichGermany Barcelona Institute for Global Health ISGlobal08003 BarcelonaSpain CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038)Institute of Health Carlos Ⅲ(ISCⅢ)28029 MadridSpain Unit of Investigation in Human Nutrition Growth and Development of Galicia(GALINUT)University of Santiago de Compostela(USC)Santiago de CompostelaSpain Pediatric Nutrition Research Group Institute of Sanitary Research of Santiago de Compostela(IDIS)CHUS-USC15706 Santiago de CompostelaSpain Unit of Pediatric Gastroenterology Hepatology and NutritioPediatric ServiceUniversity Clinical Hospital of Santiago(CHUS)15706 Santiago de CompostelaSpain GENUD Research group Institute of Sanitary Research of Aragón(IIS Aragón)University of ZaragozaZaragozaSpain Instituto Agroalimentario de Aragón(IA2) Universidad de Zaragoza-CITAZaragozaSpain Unit of Pediatric Endocrinology University Clinical Hospital Lozano Blesa50009 ZaragozaSpain Metabolism and Investigation Unit Reina Sofa University HospitalMaimónides Institute of Biomedicine Research of Córdoba(IMIBIC)University of Córdoba14071 CórdobaSpain

Objectives To evaluate whether there is an association between the serum levels of the novel insulin-like adipokine isthmin-1(ISM1)and obesity-related phenotypes in a population of Spanish children and to investigate the plausible molecular alterations behind the alteration of the serum levels of this protein in children with *** The study population is a sub-cohort of the PUBMEP research project,consisting of a cross-sectional population of 119 pubertal children with overweight(17 boys,19 girls),obesity(20 boys,25 girls),and normal weight(17 boys,21 girls).All subjects were classified into experimental groups according to their sex,obesity,and insulin resistance(IR)*** were counted anthropometry,glucose and lipid metabolism,inflammation and cardiovascular biomarkers as well as isthmin-1(ISM1)serum *** population was intended as a discovery population to elucidate the relationship between obesity and ISM1 levels in ***,the study population had blood whole-genome DNA methylation examined,allowing deepening into the obesity–ISM1 molecular *** Higher serum ISM1 levels were observed in boys with obesity than in normal weight(P=0.004)and overweight(P=0.007)***1 serum levels were positively associated with body mass index(BMI)Z-score(P=0.005)and fat mass(P=0.058)and negatively associated with myeloperoxidase(MPO)(P=0.043)in *** we did not find associations between ISM1 serum levels and metabolic outcomes in girls,which may indicate a putative sexual dimorphism,fat mass was positively associated in all children,including boys and girls(P=0.011).DNA methylation levels in two-enhancer-related CpG sites of ISM1(cg03304641 and cg14269097)were associated with serum levels of ISM1 in *** ISM1 is associated with obesity in boys at the pubertal stage,elucidating how this protein might be of special relevance as a new biomarker of obesity in *** studies including a longitudina

关键词： Children Epigenetics Isthmin-1 Obesity Puberty

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ECG after near-drowning mimicking acute coronary syndrome with left main coronary artery involvement

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World Journal of Emergency Medicine 2013年第1期4卷 75-76页

作者： Alfredo Vidal García Javier Lacunza ruiz jos. María Lpez Ayala Mariano Valdés Department of Cardiology Hospital Virgen ArrixacaCtraMurcia-Cartagena s/nEl Palmar(Murcia)30120Spain

We present the case of a 74-year-old man with diabetes and hypertension who had to be rescued owing to a near-drowning syndrome at *** he was rescued,he complained of dyspnea and chest *** electrocardiogram(ECG)suggested acute coronary syndrome(ACS)affecting the left main coronary ***,he was referred to our hospital for urgent coronary angiography.

关键词： coronary syndrome artery involvement

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Effect of Packaging Conditions on Shelf-Life of Mortadella Made with Citrus Fibre Washing Water and Thyme or Rosemary Essential Oil

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Food and Nutrition Sciences 2011年第1期2卷 1-10页

作者： Manuel Viuda-Martos Yolanda ruiz-Navajas Juana Fernández-López jos. Angel Pérez-álvarez 不详

The “elimination” of chemical additives used in a wide variety of foods is demanded, while “natural” additives are seen as a benefit for both quality and safety. Researchers are looking for new sources of ingredients and/or additives. The aim of this work was to study the effect of 1) the addition of 5.00% citrus fibre washing water (CFWW) and 0.02% rosemary essential oil (REO) or 0.02 % thyme essential oil (TEO) and 2) storage conditions on the chemical, microbe- ological and sensorial properties of mortadellas, a bologna-type sausage. CFWW + REO or CFWW + TEO samples stored in vacuum packaging showed the lowest TBA values. The resulting products were packed either in vacuum, modified atmosphere or air pouches and stored for 24 days. Lipid oxidation was assessed by the TBA method, while a quantitative descriptive analysis was carried out for sensory evaluation. Microbiological counts were also determined. CFWW + REO samples stored in vacuum packaging showed the lowest counts of aerobic and lactic acid bacteria. The sensory evaluation provided similar scores for CFWW + REO and CFWW + TEO samples. The lowest scores were obtained for control mortadella stored in air packaging. The addition of citrus fibre washing water and spice essential oils is a technologically viable alternative in emulsified meat products, since they improve customer acceptance and have desirable effects as regards oxidative stability and reduced microbial growth, which contributes to prolonging their shelf-life.

关键词： Essential Oils Cooked Meat Co-Products Shelf-Life

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Early tacrolimus exposure does not impact long-term outcomes after liver transplantation

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World Journal of Hepatology 2021年第3期13卷 362-374页

作者： Mikel Gastaca Patricia ruiz Javier Bustamante Lorea Martinez-Indart Alberto Ventoso jos.Ramón Fernandez Ibone Palomares Mikel Prieto Milagros Testillano Patricia Salvador Maria Senosiain Maria Jesus Suárez Andres Valdivieso Department of HPB Surgery and Liver Transplantation Unit Hospital Universitario CrucesBilbao 48903Spain Department of Hepatology Unit Hospital Universitario CrucesBilbao 48903Spain Department of Bioinformatics and Statistics Platform Biocruces Bizkaia Health Research InstituteHospital Universitario CrucesBilbao 48903Spain

BACKGROUND Tacrolimus trough levels(TTL)during the first weeks after liver transplantation(LT)have been related with long-term renal function and hepatocellular carcinoma ***,the significance of trough levels of tacrolimus during the early post-transplant period for the long-term outcome is under debate AIM To evaluate the effect of TTL during the first month on the long-term outcomes after *** One hundred fifty-five LT recipients treated de novo with once-daily tacrolimus were retrospectively *** with repeated LT or combined transplantation were excluded as well as those who presented renal dysfunction prior to transplantation and/or those who needed induction *** were classified into 2 groups according to their mean TTL within the first month after transplantation:≤10(n=98)and>10 ng/mL(n=57).Multivariate analyses were performed to assess risk factors for patient *** Mean levels within the first month post-transplant were 7.4±1.7 and 12.6±2.2 ng/mL in the≤10 and>10 groups,*** age was higher in the high TTL group 62.9±16.8 years vs 45.7±17.5 years(P=0.002)whilst mycophenolate-mofetil was more frequently used in the low TTL group 32.7%vs 15.8%(P=0.02).Recipient features were generally similar across *** a median follow-up of 52.8 mo(range 2.8-81.1),no significant differences were observed in:Mean estimated glomerular filtration rate(P=0.69),hepatocellular carcinoma recurrence(P=0.44),de novo tumors(P=0.77),new-onset diabetes(P=0.13),or biopsy-proven acute rejection rate(12.2%and 8.8%,respectively;P=0.50).Eighteen patients died during the follow-up and were evenly distributed across groups(P=0.83).Five-year patient survival was 90.5%and 84.9%,respectively(P=0.44),while 5-year graft survival was 88.2%and 80.8%,respectively(P=0.42).Early TTL was not an independent factor for patient mortality in multivariate *** Differences in tacrolimus levels restricted to the fi

关键词： Liver transplantation Tacrolimus levels Prolonged released tacrolimus Oncedaily tacrolimus Renal function Survival Outcomes

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Medical,ethical,and legal aspects of hematopoietic stem cell transplantation for Crohn’s disease in Brazil

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World Journal of Stem Cells 2020年第10期12卷 1113-1123页

作者： Milton Artur ruiz Roberto Luiz Kaiser Junior Lilian Piron-ruiz Priscila Samara Saran Lilian Castiglioni Luiz Gustavo de Quadros Tainara Souza Pinho Richard K Burt Department of Bone Marrow Transplant Beneficência Portuguesa HospitalSão Josédo Rio Preto 15090470Brazil Department of Proctology Beneficencia Portuguesa HospitalSão Josédo Rio Preto 15090470Brazil Department of Bone Marrow Transplantation Beneficência Portuguesa HospitalSão Josédo Rio Preto 15090470Brazil Genetics and Molecular Biology FAMERP-Faculdade de Medicina de São Josédo Rio PretoSão Josédo Rio Preto 15090470 Brazil Department of Endoscopy Beneficência Portuguesa HospitalABC Medical SchoolSão Bernardo 15015110Brazil Department of Medicine Northwestern University Feinberg School of MedicineChicagoIL 60611United States

Crohn's disease(CD)is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal *** etiology of CD is unknown;however,genetic,epigenetic,environmental,and lifestyle factors could play an essential role in the onset and establishment of the *** results from immune dysregulation due to loss of the healthy symbiotic relationship between host and intestinal flora and or its *** affects both sexes equally with a male to female ratio of 1.0,and its onset can occur at any age,but the diagnosis is most commonly observed in the range of 20 to 40 years of *** diminishes quality of life,interferes with social activities,traumatizes due to the stigma of incontinence,fistulae,strictures,and colostomies,and in severe cases,affects survival when compared to the general *** fluctuate between periods of remission and activity in which complications such as fistulas,strictures,and the need for bowel resection,surgery,and colostomy implantation make up the most severe aspects of the *** can be progressive and the complications recurrent despite treatment with anti-inflammatory drugs,corticosteroids,immunosuppressants,and biological ***,over time many patients become refractory without treatment alternatives,and in this scenario,hematopoietic stem cell transplantation(HSCT)has emerged as a potential treatment *** rationale for the use of HSCT for CD is anchored in animal studies and human clinical trials where HSCT could reset a patient's immune system by eliminating disease-causing effector cells and upon immune recovery increase regulatory and suppressive immune *** HSCT using a non-myeloablative regimen of cyclophosphamide and anti-thymocyte globulin without CD34+selection has been to date the most common transplant conditioning regimen *** this review we will address the current situation regarding CD treatment with HSCT and emphasize the medical,ethical,and legal aspect

关键词： Crohn disease Hematopoietic stem cell transplant Stem cell therapy Autologous transplant Ethics Treatment

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Insecticidal Effects of the Annonaceous Acetogenin Squamocin and the Acetogenin Fraction of Seeds of <i>Rollinia occidentalis</i>on Soybean and Corn Pests

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Journal of Agricultural Chemistry and Environment 2014年第4期3卷 156-160页

作者： Diego Tolosa jos. ruiz Hidalgo Pedro Eugenio Sal Susana Popich Alicia Bardón Adriana Neske Instituto de Química Orgánica Facultad de Bioquímica Química y Farmacia Universidad Nacional de Tucumán Ayacucho Argentina Universidad Nacional de Chilecito Chilecito Argentina INQUINOA-CONICET Tucumán Argentina

A treatment based on the acetogenin fraction of the methanol extract of Rollinia occidentalis seeds was applied to soybean crops for three consecutive years. In relation to the control population, the treatment reduced the population of Anticarsia gemmatalis, Rachiplusia nu, Pseudoplusia includens, Loxostege bifidalis and Spodoptera frugiperda to 52% and 65% after 48 h of application at concentrations of 500 and 750 μg/mL respectively, while low toxic effects were detected on natural enemies. The extract treatment at 500 μg/mL and a solution of the annonaceous acetogenin, squamocin, at 50 and 100 μg/mL, were also applied to a corn field to produce 75%, 93% and 100% mortality rates on the population of S. frugiperda, respectively, after 72 h of application. In addition, damages caused by lepidopterans in treated crops were lower than those observed in non treated fields, evaluated by residual biomass. This statement is based on data from trials with the commercially available insecticides lufenuron and cypermethrin.

关键词： Annonaceous Acetogenins Polyphagous Lepidopteran Soybean Crops Corn Crops Spodoptera frugiperda

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