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Analyses of the genetic diversity of indigenous cattle are essential for implementing conservation programs, promoting their sustainable use and maintaining productive advantages offered by these breeds in local conditions. The aim of this study was to investigate the genetic diversity and population structure of six Colombian cattle breeds: Blanco Orejinegro (BON), Costeño con Cuernos (CCC), Romosinuano (ROM), Sanmartinero (SAM), Casanareño (CAS), and Hartón del Valle (HDV). Two additional breed groups were included for comparison: Zebu (CEB) and a crossbreed of Colombian cattle breeds × Zebu. Genetic diversity within breeds was analyzed using expected heterozygosity (He), inbreeding coefficient (f), and runs of homozygosity (ROH). Population structure was assessed using model-based clustering (ADMIXTURE) and principal components analysis (PCA). Zebu cattle showed the lowest genetic diversity (He = 0.240). Breeds with the highest genetic diversity level were HDV and BON (He = 0.350 and 0.340, respectively). Inbreeding was lower for Colombian cattle breeds ranging between 0.005 and 0.045. Overall, the largest average genetic distance was found among the group of Colombian cattle breeds and Zebu, while the smallest was found between ROM and CCC. Model-based clustering revealed some level of admixture among HDV and CAS cattle which is consistent with their recent history. The results of the present study provide a useful insight on the genetic structure of Colombian cattle breeds.

Objective: Retrospective case-matched comparison of magnetic liver retraction to a bedrail-mounted liver retractor in bariatric surgery specifically targeting short-term postoperative outcomes, including pain and resource utilization. Background: Retraction of the liver is essential to ensure appropriate visualization of the hiatus in bariatric surgery. Externally mounted retractors require a dedicated port or an additional incision. Magnetic devices provide effective liver retraction without the need of an incision. Methods: The sample consisted of primary and revisional bariatric surgery patients, including Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and biliopancreatic diversion with duodenal switch (BPD-DS) operations. Propensity score analysis was used to match patients with magnetic retraction to patients with a bedrail-mounted retractor with a 1:2 ratio using preoperative characteristics. Baseline characteristics and postprocedure outcomes were compared using two-sample t-tests or Wilcoxon rank sum tests and chi-square or Fisher's exact test as appropriate. Results: One hundred patients met inclusion criteria for the use of magnetic liver retraction (45 RYGB, 35 SG, 20 BPD-DS) with 196 suitable matched external retractor patients identified. Patients were matched and comparable for all preoperative characteristics except for transversus abdominus plane block (27% versus 47%). Patients in the magnet cohort had significantly decreased mean 12-hour postoperative pain scores (2.9 versus 4.2, P = .004) and decreased hospital length of stay (LOS) (1.5 versus 1.9 days, P = .005) while operating room supply were higher in the magnet cohort ($4600 versus $4213, P = .0001). Conclusions: Magnetic liver retraction in bariatric surgery is associated with decreased postoperative pain scores, decreased hospital LOS, and increased operating supply costs.

The abdominal wall and musculoskeletal tendons share many anatomic, physiologic, and functional characteristics. This review aims to highlight these similar characteristics and to present a rationale why the treatment principles of successful musculoskeletal tendon reconstruction, including principles of surgical technique and physical therapy, can be used in the treatment of complex abdominal wall reconstruction or ventral hernia repair. The MEDLINE/PubMed database was used to identify published literature relevant to the purpose of this review. There are several anatomical and functional similarities between the linea alba and musculoskeletal tendons. Because of this reason, many of the surgical principles for musculoskeletal tendon repair and ventral hernia repair overlap. Distribution of tension is the main driving principle for both procedures. Suture material and configuration are chosen to maximize tension distribution among the tissue edges, as seen in the standard of care multistrand repairs for musculoskeletal tendons, as well as in the small bites for laparotomy technique described in the STITCH trial. Physical therapy is also one of the mainstays of tendon repair, but surprisingly, is not routine in ventral hernia repair. The evidence surrounding physical therapy prehabilitation and rehabilitation protocols in other disciplines is significant. This review challenges the fact that these protocols are not routinely implemented for ventral hernia repair, and presents the rationale and feasibility for the routine practice of physical therapy in ventral hernia repair.

Background Racial disparities in postoperative complications have been demonstrated in bariatric surgery, yet the relationship of race to complication severity is unknown. Study Design Adult laparoscopic primary bariatric procedures were queried from the 2015 and 2016 MBSAQIP registry. Adjusted logistic and multinomial regressions were used to examine the relationships between race and 30-day complications categorized by the Clavien-Dindo grading system. Results A total of 212,970 patients were included in the regression analyses. For Black patients, readmissions were higher (OR = 1.39, p

Endoscopy is essential in the assessment and treatment of the bariatric patient, especially in the postoperative state. Since bariatric surgery is increasing exponentially, endoscopists should be familiar with the anatomy and how to manage possible complications. New less invasive therapeutic tools will have a major impact on the prognosis of these patients. Dreaded complications such as leaks, stenosis or weight regain can be successfully assessed and treated by endoscopy. Postoperative evaluation of symptoms requires the precise search of details that can change patient's management.

Background The DiaRem score has proven to be a reliable predictor tool for diabetes remission in Roux-en-Y gastric bypass (RYGB), as well as laparoscopic adjustable gastric band (LAGB) and laparoscopic sleeve gastrectomy (LSG). To our knowledge there are no studies that analyze DiaRem in patients undergoing biliopancreatic diversion with duodenal switch (BPD/DS). Objective To test the validity of the DiaRem score as a predictor of type 2 diabetes remission at 1 year post surgery in patients who underwent LABG, LSG, RYGB, and BPD/DS, as well as to develop and test a novel model that uses DiaRem to predict type 2 diabetes remission by procedure type (LABG, LSG, RYGB, and BPD/DS). Setting University Medical Center, United States. Methods A retrospective review of institutional records identified patients who underwent primary bariatric procedures (LAGB, LSG, RYGB, and BPD/DS) between January 1, 2000 to April 10, 2017, had a diagnosis of diabetes and had complete preoperative and 1-year postoperative follow-up information. A univariable logistic regression model was fit to assess the association between DiaRem score and diabetes remission. A multivariable logistic regression model was created, including procedure type and other preoperative characteristics. The area under the receiver operating curve (AUROC) was calculated to analyze the performance of both models for the entire cohort as well as a BPD/DS only subgroup. Results A total study cohort of 602 was obtained. The majority of patients underwent RYGB (456; 75.7%), followed by LSG (84; 14.0%), BPD/DS (35; 5.8%), and LAGB (27; 4.5%). The multivariable regression model with RYGB as the reference procedure, showed that BPD/DS results in higher odds of type 2 diabetes remission at 1 year post surgery (adjusted odds ratio [OR] 3.29, 95% confidence interval [CI] 1.27, 8.51), while LSG (adjusted OR .52, 95%CI .29, .93) and LAGB resulted in lower odds (adjusted OR.23, 95% CI.09,.60). The univariable DiaRem model and the novel model were determined to be moderately strong in classifying diabetes remission in the entire cohort (AUROC: .79, 95% CI: .75, .83 and .82, 95% CI: .79, .85, respectively) as well as in the BPD/DS sub-group (AUROC: .85, 95% CI: .70, .99 and .84, 95% CI .69, .99, respectively). Conclusion Our study shows that the DiaRem score is a reliable tool to predict diabetes remission, amongst a wide variety of different procedures as well as specifically those receiving BPD/DS. Our novel model, which takes into account procedure type, not only shows that BPD/DS patients have the highest odds of diabetes remission than other procedures, but also that this model performs significantly better at predicting diabetes remission than DiaRem alone.

This study aims to determine if cosmetic outcomes play an important role for patients undergoing bariatric surgery, when considering a surgical approach. A video-animation describing open, conventional laparoscopic, and reduced incision magnetic assisted surgery was shown. The patient's perceptions of the surgical approaches were recorded using an anonymous survey. Fifty-one patients completed the survey. The median age was 45 (IQR: 36-51), and 38 (74.5%) were women. Cosmesis was found to be an important factor (77%) for selecting a surgical approach. Ninety percent of the patients believe that reduced incision magnet-assisted surgery provides superior cosmesis. Cosmetic results may play a determinant role when choosing a surgical approach.

Background and study aims Sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure in the world. Leaks are the most feared complications after this procedure. Endoscopic septotomy has been described as a resolution technique that could be useful in the setting of late and chronic leaks. We present our experience in the management of gastric leaks with this advanced endoscopic technique. Patients and methods Retrospective review of patients who have been admitted to our hospital from January 2016 to December 2018. Results Five patients were found. All had their index surgery in outside hospitals. The average age was 51 years (range 40 – 69), and four patients were female. Mean time from LSG to leak presentation was 15 days (range 7 – 25). Mean time from leak presentation to septotomy procedure was 61 days (range 21 – 110). All patients were treated with sleeve dilatation before septotomy using endoscopic achalasia balloons. Mean procedure time was 79 minutes (range 55 – 125). Success was achieved in 80 % of patients, and no complications related to the procedure were identified. One patient underwent total gastrectomy for definitive management. Mean follow-up time was 14.25 months (range 6 – 26), and the average time for fistula closure was 60.25 days. Conclusion Endoscopic septotomy is safe and effective for management of chronic leaks after LSG. Associated non-selective dilatation may be a crucial step to allow distal patency and axis rectification for appropriate leak closure.

Background Vocal Cord Dysfunction (VCD) is a respiratory condition in which vocal cords restrict airflow by closing during inspiration. Symptoms include shortness of breath, coughing, chest tightness and wheezing. These symptoms are commonly reduced with breathing exercises to relax the chest and throat. VCD is often misdiagnosed as asthma and treated as such. Studies have shown that steroids used to treat asthma are not beneficial in the treatment of VCD, and are therefore unnecessary. Recent studies suggest that Botox injections to relax the thyroarythenoid muscles surrounding vocal cords resulting in an improvement in the patient's airflow. Methods We followed a 56-year-old female patient over the course of a year who had a history of upper espiratory infections, sinusitis, allergic rhinitis and asthma reporting an increase in the severity of respiratory symptoms even though successfully undergoing immunotherapy treatment and following a regimen of asthma medication. Her symptoms included shortness of breath, wheezing and trouble sleeping. Results Pulmonary function testing done elsewhere revealed that the patient had a reduced lung capacity. After a consult with a speech pathologist, VCD and Spastic Dysphonia (SD) were diagnosed. The symptoms where initially treated with speech therapy. Four months later the patient noted a slight improvement in her symptoms, but also attributed this to the fact that she had developed behavioral ways to cope with symptoms. The possibility of Botox injections was mentioned and the patient agreed to follow with this treatment. Two 2.5 unit injections of Botox were administered in the thyroarythenoid muscles via an EMG guided needle, without any complications. The results from the procedure were very favorable. All her symptoms improved significantly. Lung function tests appeared normal, and she was able to reduce the use of most asthma control medications. She received another dose of Botox injections 6 months following the first, and continues to do very well. Conclusions Botox injections in the thyroarythenoid muscles are a successful treatment option for VCD patients with dysphonia. With this treatment patients are able to minimize respiratory symptoms and inhaled steroid use. A larger, randomized study with patients diagnosed with VCD alone should be considered.

Background Eosinophilic Esophagitis (EoE) is an inflammatory disease that reduces the ability of the esophagus to pass food, often leading to dysphagia. A relationship between EoE and food allergies has been determined. However, there have been several documented cases in which patients had negative prick skin testing (PST) results for food allergens and positive results for airborne environmental allergens, and still have a confirmed diagnosis of EoE. Recently, airborne allergens have been implicated in the onset of this condition. Studies have shown that patients sensitive to airborne allergens such as pollen have a seasonal biannual component in which the severity of EoE symptoms increase, coinciding with high pollen seasons. Methods We followed a 65-year-old man with a history of allergies complaining of an increase in his symptoms of allergic rhinitis and asthma. He also noted dysphagia and occasional vomiting. We noted the disease and medication course over 5 years of treatment. Results The patient underwent an esophagogastroduodenoscopy with biopsy, in which midesophageal rings as well as an 8 mm sessile polyp were found, suggesting EoE. Histological analysis confirmed EoE, having found >20 intraepithelial eosinophils/HPF. The patient was treated with a short term prednisone regimen, as well as maintenance medications consisting of inhaled corticosteroids and antihistamines. The patient returned 6 months after the initial consultation and still presented symptoms of EoE, at which point the patient was prescribed proton pump inhibitors. In addition, allergen specific immunotherapy was initiated for confirmed airborne allergens. The patient was examined after 5 years of immunotherapy treatment. Not only did he report that his allergic rhinitis and asthma symptoms were controlled, but his EoE symptoms had resolved. Conclusions Results suggest that immunotherapy for airborne allergens could be a successful treatment for EoE. A larger study is needed to determine if allergen specific immunotherapy is a viable treatment option for EoE in similar cases. Such a study could include patients with EoE and confirmed airborne allergies treated with immunotherapy while monitoring a number of eosinophilic and lymphocytic markers.

The huge biological diversity of the Brazilian Cerrado is an important source of economically interesting microbial agents. The phylum Actinobacteria plays an important role in nutrient cycling, potentially improving their availability to plants. In this study, we isolated an actinobacteria (strain 3AS4) from wheat rhizospheres of crops cultivated in the Cerrado biome. Strain 3AS4 was identified as belonging to the genus Streptomyces and had phosphorus mobilization ability, mineralizing approximately 410 mg ml-1 from phytate, 300 mg ml-1 from calcium phosphate, and 200 mg ml-1 from rock phosphate. The analysis of the actinobacteria crude extract by spectrometric techniques revealed the presence of gluconic and 2-ketogluconic acid, and a greenhouse experiment was carried out to evaluate its plant growth promotion activity in soybean. Soil in its natural condition (with no phosphorus addition), 40 kg ha􀀀1 rock phosphate from Bayovar (RP) added to soil, and triple super phosphate (SPT) added to soil were used. Significant differences in plant height were observed at 6 weeks when the plants were inoculated with the 3AS4 strain. The growth of inoculated plants in natural condition was promoted in 17% compared with the RP and SPT non-inoculated conditions, suggesting that inoculation can enable plants to grow with lower chemical P fertilizers. In the plants that were inoculated with the 3AS4 strain in the RP condition, the plant height increased by approximately 80% and the shoot:root ratio was approximately 30% higher compared to control conditions (non-inoculated plants in natural conditions). 3AS4 has P-solubilizing potential and can be exploited as an inoculant for soybean cultivation. These results suggest that this actinobacterium is a valuable resource for sustainable agriculture and will allow the reduction of phosphate fertilization in the future. Made available in DSpace on 2021-08-12T18:00:25Z (GMT). No. of bitstreams: 1 Queiroz-Actinobacterium-strain-2021.pdf: 1861839 bytes, checksum: 1086e2f573058785947282cdc37c76b1 (MD5) Previous issue date: 2021

Background Modern crop varieties are typically cultivated in agriculturally well-managed soils far from the centers of origin of their wild relatives. How this habitat expansion impacted plant microbiome assembly is not well understood. Results Here, we investigated if the transition from a native to an agricultural soil affected rhizobacterial community assembly of wild and modern common bean (Phaseolus vulgaris) and if this led to a depletion of rhizobacterial diversity. The impact of the bean genotype on rhizobacterial assembly was more prominent in the agricultural soil than in the native soil. Although only 113 operational taxonomic units (OTUs) out of a total of 15,925 were shared by all eight bean accessions grown in native and agricultural soils, this core microbiome represented a large fraction (25.9%) of all sequence reads. More OTUs were exclusively found in the rhizosphere of common bean in the agricultural soil as compared to the native soil and in the rhizosphere of modern bean accessions as compared to wild accessions. Co-occurrence analyses further showed a reduction in complexity of the interactions in the bean rhizosphere microbiome in the agricultural soil as compared to the native soil. Conclusions Collectively, these results suggest that habitat expansion of common bean from its native soil environment to an agricultural context had an unexpected overall positive effect on rhizobacterial diversity and led to a stronger bean genotype-dependent effect on rhizosphere microbiome assembly. Electronic supplementary material The online version of this article (10.1186/s40168-019-0727-1) contains supplementary material, which is available to authorized users.