Objective:Minimally invasive surgery(MIS)techniques such as laparoscopy and robotic surgery for colorectal resection have been cited as superior to traditional open surgery because of their associations with decreased...Objective:Minimally invasive surgery(MIS)techniques such as laparoscopy and robotic surgery for colorectal resection have been cited as superior to traditional open surgery because of their associations with decreased operating room time,hospital stay length,and postoperative morbidity.Despite these benefits,the open approach remains a common surgical method for colorectal resection procedures.We aim to evaluate the most recent yearly trends in open,laparoscopic,and robotic approaches to provide insight into uptake and present the status of MIS in the field of colorectal surgery.Methods:Data were collected from the American College of Surgeons National Surgical Quality Improvement Program targeted colectomy database for the years 2014e2020.The surgical approach was classified as either open,laparoscopic,or robotic.Analysis was performed to identify trends in colorectal surgery categorized by year,patient age,American Society of Anesthesiologists(ASA)classification,body mass index(BMI),and emergency status.Results:There was an overall decline in both open and laparoscopic surgery cases(from 38.4%to 34.4%and from 57.4%to 50.8%,respectively)and an overall increase in robotic surgery cases(from 4.2%to 14.8%)from 2014 through 2020.Open surgery was the most common approach for the lowest BMI category(<18.5 kg/m2),highest risk ASA classes(4e5)and most emergent surgeries,whereas robotic surgery rates were negligible for these groups.Laparoscopy was the most prevalent approach for all other categories.Conclusion:Laparoscopy was the most prevalent approach in colorectal surgery,although the total case proportions generally tended to decrease.While open surgery remains the approach of choice for emergent procedures,laparoscopic case proportions increased marginally in this category,likely owing to increases in surgeon comfort and continued expansion of laparoscopic training efforts.Importantly,the total prevalence of robotic surgery increased significantly between 2014 and 2020,which may be attributable to advancements in the robotic platform and increases in familiarity and competence with the technology.We anticipate a continuation of these trends in the future and recommend the creation of a national robotic surgery training standard.展开更多
Contact with environmental microbes are arguably the most common species interaction in which any animal participates.Studies have noted diverse relationships between hosts and resident microbes,which can have strong ...Contact with environmental microbes are arguably the most common species interaction in which any animal participates.Studies have noted diverse relationships between hosts and resident microbes,which can have strong consequences for host development,physiology,and behavior. Many of these studies focus specifically on pathogens or beneficial microbes,while the benign microbes,of which the majority of bacteria could be described,are often ignored.Here,we explore the nature of the relationships between the grass spider Agelenopsis pennsylvanica and bacteria collected from their cuticles in situ.First,using culture-based methods,we identified a portion of the cuticular bacterial communities that are naturally associated with these spiders.Then,we topically exposed spiders to a subset of these bacterial monocultures to estimate how bacterial exposure may alter 3 host behavioral traits:boldness,aggressiveness,and activity level.We conducted these behavioral assays 3 times before and 3 times after topical application,and compared the changes observed in each trait with spiders that were exposed to a sterile control treatment.We identified 9 species of bacteria from the cuticles of 36 spiders and exposed groups of 20 spiders to 1 of 4 species of cuticular bacteria.We found that exposure to Dermacoccus nishinomiyaensis and Staphylococcus saprophyticus was associated with a lO-fold decrease in the foraging aggressiveness of spiders toward prey in their web.Since bacterial exposure did not have survival consequences for hosts,these data suggest that interactions with cuticular bacteria,even non- pathogenic bacteria,could alter host behavior.展开更多
文摘Objective:Minimally invasive surgery(MIS)techniques such as laparoscopy and robotic surgery for colorectal resection have been cited as superior to traditional open surgery because of their associations with decreased operating room time,hospital stay length,and postoperative morbidity.Despite these benefits,the open approach remains a common surgical method for colorectal resection procedures.We aim to evaluate the most recent yearly trends in open,laparoscopic,and robotic approaches to provide insight into uptake and present the status of MIS in the field of colorectal surgery.Methods:Data were collected from the American College of Surgeons National Surgical Quality Improvement Program targeted colectomy database for the years 2014e2020.The surgical approach was classified as either open,laparoscopic,or robotic.Analysis was performed to identify trends in colorectal surgery categorized by year,patient age,American Society of Anesthesiologists(ASA)classification,body mass index(BMI),and emergency status.Results:There was an overall decline in both open and laparoscopic surgery cases(from 38.4%to 34.4%and from 57.4%to 50.8%,respectively)and an overall increase in robotic surgery cases(from 4.2%to 14.8%)from 2014 through 2020.Open surgery was the most common approach for the lowest BMI category(<18.5 kg/m2),highest risk ASA classes(4e5)and most emergent surgeries,whereas robotic surgery rates were negligible for these groups.Laparoscopy was the most prevalent approach for all other categories.Conclusion:Laparoscopy was the most prevalent approach in colorectal surgery,although the total case proportions generally tended to decrease.While open surgery remains the approach of choice for emergent procedures,laparoscopic case proportions increased marginally in this category,likely owing to increases in surgeon comfort and continued expansion of laparoscopic training efforts.Importantly,the total prevalence of robotic surgery increased significantly between 2014 and 2020,which may be attributable to advancements in the robotic platform and increases in familiarity and competence with the technology.We anticipate a continuation of these trends in the future and recommend the creation of a national robotic surgery training standard.
文摘Contact with environmental microbes are arguably the most common species interaction in which any animal participates.Studies have noted diverse relationships between hosts and resident microbes,which can have strong consequences for host development,physiology,and behavior. Many of these studies focus specifically on pathogens or beneficial microbes,while the benign microbes,of which the majority of bacteria could be described,are often ignored.Here,we explore the nature of the relationships between the grass spider Agelenopsis pennsylvanica and bacteria collected from their cuticles in situ.First,using culture-based methods,we identified a portion of the cuticular bacterial communities that are naturally associated with these spiders.Then,we topically exposed spiders to a subset of these bacterial monocultures to estimate how bacterial exposure may alter 3 host behavioral traits:boldness,aggressiveness,and activity level.We conducted these behavioral assays 3 times before and 3 times after topical application,and compared the changes observed in each trait with spiders that were exposed to a sterile control treatment.We identified 9 species of bacteria from the cuticles of 36 spiders and exposed groups of 20 spiders to 1 of 4 species of cuticular bacteria.We found that exposure to Dermacoccus nishinomiyaensis and Staphylococcus saprophyticus was associated with a lO-fold decrease in the foraging aggressiveness of spiders toward prey in their web.Since bacterial exposure did not have survival consequences for hosts,these data suggest that interactions with cuticular bacteria,even non- pathogenic bacteria,could alter host behavior.
