Two teenagers whose fingers were cut off in a game of tug-of-war at a school in California are awake and alert after surgery, a medical official says.

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An official review concluded Leeds General Infirmary should stop surgery so care could be concentrated at fewer, larger sites to improve standards.

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Under the 2004 Gender Recognition Act, the UK does not require genital surgery before allowing individuals to obtain official recognition of their new gender.

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The ministry confirmed the government has seen cases of poor surgery but didn't elaborate on official penalties.

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An official review concluded in July that Leeds General Infirmary should stop surgery so care could be concentrated at fewer, larger sites to improve standards.

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On Sunday, another Venezuelan official said the president was "gaining strength" following complications after cancer surgery on 11 December.

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His family announced on his official website that he unexpectedly died on 6 March following complications during routine surgery.

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Still, she says, the family was awe-struck when they came to check in for surgery at the completed facility last April, ahead of the official opening.

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