Successful de-implementation of an ineffective practice: The fall of docusate.

Background: Reducing wasteful practices optimizes value in medicine. Docusate lacks treatment efficacy yet is widely prescribed. This quality improvement project aimed to de-implement docusate in place of a new evidence-based order set.

Towards identifying a learning curve for robotic abdominal wall reconstruction: a cumulative sum analysis.

Introduction: Over the past decade, an increase has been seen in robotics used for hernia repair, specifically robotic abdominal wall reconstruction (rAWR). However, the learning curve for rAWR can be steep and presently, little is understood regarding the optimal case volume required to achieve proficiency. The aim of our study was to review skill acquisition and describe the learning curve for rAWR.

Surgeon perspectives on the STITCH trial: a mixed methods study.

Background: Incisional hernia prevention strategies related to fascial closure technique during laparotomy are well described yet poorly implemented in practice. The factors hindering the surgeon's adoption of evidence-based techniques for fascial closure are poorly understood and characterized.

Methods: Using an exploratory sequential mixed methods design, we first collected 139 responses to a validated quantitative survey based on a Theoretical Domain Framework for adoption of healthcare practices.

The formaldehyde treated guar meal and prill fat, agro industrial by-products as dietary rumen protected protein and energy source: improves growth performance, feed conversion, nutrient utilization, microbial protein synthesis, blood metabolites and economic efficiency in growing dairy buffalo (Bubalus bubalis) calves.

The study investigated the effects of protein replacement with formaldehyde-treated guar meal (FTGM) and prill fat (PF) in the diet on performance of growing dairy buffalo calves. Thirty-two feedlots Surti breed dairy buffalo calves (age, 7.31 ± 0.

A retrospective single-institution review of the impact of COVID-19 on severity of biliary disease.

Background: The COVID-19 pandemic possessed far-reaching health implications beyond the public health impact that have yet to be fully elucidated. We hypothesized that the COVID-19 pandemic led to an increase in biliary disease complexity and incidence of emergency cholecystectomy.

Methods: We reviewed our institutional experience with cholecystectomy from February 2019-February 2021, n = 912.

Retrospective Evaluation of Short-Term Outcomes of an Enhanced Recovery Protocol for Patients Undergoing Complex Abdominal Wall Reconstruction.

Background: Enhanced recovery protocols (ERPs) have the potential to streamline care and improve short-term outcomes for surgical patients. However, for patients undergoing modern iterations of complex abdominal wall reconstruction (AWR), little literature exists on the effectiveness of these protocols.

Study Design: In this retrospective study we reviewed our institutional experience with complex AWR throughout a 2-year period with 1 year immediately before and 1 year after implementation of our ERP.

Comparative clinical evaluation of a self-adhering flowable composite with conventional flowable composite in Class I cavity: An study.

Context: The purpose of this study was to evaluate the efficiency of self-adhering flowable composite with that of a time-tested conventional flowable composite. Since the self-adhering composite reduces chair time and is convenient to use, its clinical behavior was monitored for a year.

Aim: This study aimed to evaluate the clinical behavior of self-adhering flowable composite - Fusio Liquid Dentin - in small-sized Class I cavities and also to compare it with conventional flowable composite - Tetric N-Flow - bonded to the tooth structure with fifth-generation two-step-etch-and-rinse adhesive.

A case report on endodontic management of the rarest Vertucci's Type VIII configuration in maxillary second molar with three mesiobuccal canals.

Anatomic variations in mesiobuccal root (MBR) of maxillary molars are common. This variation is found to be more common in maxillary first molars as compared to second molars. However, finding three independent mesiobuccal (MB) canals in the MBR of maxillary molars is clinically a rare entity.

Effect of chemical cross-linkers on surface topography and microtensile bond strength of sound dentin: An study.

Aim And Objectives: The aim of the study was to investigate the effect of two different collagen cross-linking agents proanthocyanidin (Grape seed extract [GSE] and 1-Ethyl-3-(3-dimethylaminopropyl) carbodiimide) on the surface topography of etched dentin and microtensile bond strength (μTBS) of resin dentin bond.

Materials And Methods: Fifty-two sound human 3 molars were collected, and their occlusal surfaces were ground flat to expose dentin. Dentin surfaces were etched using phosphoric acid and then teeth were randomly divided into four groups, according to the dentin treatment: Group 1: wet bonding technique, Group 2: dry bonding technique, Group 3: 6.

Comparative evaluation of different direct pulp capping agents in carious tooth: An study.

Background: The success of direct pulp capping (DPC) depends on the preoperative assessment of pulpal status, intraoperative judgment after pulp exposure, and the biomaterials used to cap the pulp.

Aim: The study aims to compare the clinical and radiographic responses of the pulp-dentin complex after DPC with TheraCal LC, Biodentine, and current gold standard mineral trioxide aggregate (MTA) Plus.

Materials And Methods: Ninety vital permanent teeth with Class I deep carious lesions were randomly divided into three different groups.

Comparative analysis of the naso/oropharyngeal swab and oral bio-fluid (whole saliva) samples for the detection of SARS-CoV-2 using RT-qPCR.

Context: The Corona Virus Disease 2019 (COVID-19) is a contagious disease caused by the novel Coronavirus (2019-nCoV) and was declared a pandemic disease by the World Health Organization (WHO) in March 2020. The nasopharyngeal and the oropharyngeal swabs are being taken during the screening procedure. However, the virus is also present in the oral bio-fluid and hence it could be a potential tool for screening COVID-19 cases.

Evaluation of cell viability of Human Dental Pulp Stem Cells in Two dimensional and Three dimensional Fibrin Glue Scaffold.

Context: Regenerative endodontics uses the concept of tissue engineering to restore the diseased immature tooth, allowing for continued development of the root to a healthy state. For regenerative endodontics, the use of human dental pulp stem cells (HDPSCs) with appropriate scaffolds and growth factors is imperative.

Aims: The aim of the study was to evaluate the human dental pulp cell viability in two-dimensional (2D) and 3D fibrin glue scaffold to be used in regenerative endodontics.

Patient, Nurse, Medical Assistant, and Surgeon Perspectives Inform the Development of a Decision Support Tool for Inguinal Hernia Surgery: A Qualitative Analysis.

Background: Critical perspectives on the informed consent process for inguinal hernia surgery are lacking.

Methods: We conducted focus group interviews of patients who have undergone inguinal hernia surgery and nurses/medical assistants. Individual phone interviews were also conducted with surgeons sampled from the International Hernia Collaboration.

Standoff pump-probe photothermal detection of hazardous chemicals.

A novel pump-probe Photothermal methodology using Quartz Tuning Fork (QTF) detector has been demonstrated for the first time. A tunable mid-IR Quantum Cascade Laser (QCL) and a CW fixed wavelength visible laser have been used as the pump and probe beam respectively. The developed Photothermal (PT) technique is based on Quartz Tuning Fork (QTF) detector for the detection of hazardous/explosive molecules adsorbed on plastic surface and also in aerosols form.

Leakage of an Invagination Pancreaticojejunostomy May Have an Influence on Mortality.

No consensus exists regarding the most effective form of pancreaticojejunostomy (PJ) following pancreaticoduodenectomy (PD). Data were gathered through the American College of Surgeons-National Surgical Quality Improvement Program, Pancreatectomy Demonstration Project. A total of 1781 patients underwent a PD at 43 institutions.

Gastric Ischemic Conditioning Prior to Esophagectomy Is Associated with Decreased Stricture Rate and Overall Anastomotic Complications.

Background: Gastric ischemic conditioning prior to esophagectomy can increase neovascularization of the new conduit. Prior studies of ischemic conditioning have only investigated reductions in anastomotic leaks. Our aim was to analyze the association between gastric conditioning and all anastomotic outcomes as well as overall morbidity in our cohort of esophagectomy patients.

Two-Stage Explantation of a Magnetic Lower Esophageal Sphincter Augmentation Device Due to Esophageal Erosion.

Introduction: Implanting a magnetic lower esophageal sphincter augmentation device (LINX, Torax Medical) has become an increasingly common option in the surgical management of gastroesophageal reflux disease. As the enthusiasm for placing this device increases, experience in the management of device-related complications-including erosion-is necessary.

Methods: We report a staged approach to LINX removal in a 64-year-old female with symptoms of odynophagia secondary to partial erosion of a LINX device into the esophagus.

Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients.

Background: Surgeon and hospital volume are both known to affect outcomes for patients undergoing pancreatic resection. The objective was to evaluate the relative effects of surgeon and hospital volume on 30-d mortality and 30-d complications after pancreatic resection among older patients.

Materials And Methods: The study used Texas Medicare data (2000-2012), identifying high-volume surgeons as those performing ≥4 pancreatic resections/year, and high-volume hospitals as those performing ≥11 pancreatic resections/year, on Medicare patients.

Trends in Receipt and Timing of Multimodality Therapy in Early-Stage Pancreatic Cancer.

Introduction: Pancreatic cancer is considered a systemic disease at presentation. Therefore, multimodality therapy with surgical resection and chemotherapy is the standard of care for locoregional disease. We described treatment patterns and time trends with regard to age and treatment center in the receipt of multimodality therapy.

Laparoscopy decreases complications for obese patients undergoing elective rectal surgery.

Introduction: While there are many reported advantages to laparoscopic surgery compared to open surgery, the impact of a laparoscopic approach on postoperative morbidity in obese patients undergoing rectal surgery has not been studied. Our goal was to determine whether obese patients undergoing laparoscopic rectal surgery experienced the same benefits as non-obese patients.

Methods: We identified patients undergoing rectal resections using the National Surgical Quality Improvement Project Participant Use Data File.

The risk paradox: use of elective cholecystectomy in older patients is independent of their risk of developing complications.

Background: We recently developed and validated a prognostic model that accurately predicts the 2-year risk of emergent gallstone-related hospitalization in older patients presenting with symptomatic gallstones.

Study Design: We used 100% Texas Medicare data (2000 to 2011) to identify patients aged 66 years and older with an initial episode of symptomatic gallstones not requiring emergency hospitalization. At presentation, we calculated each patient's risk of 2-year gallstone-related emergent hospitalization using the previously validated model.

Relative Contributions of Complications and Failure to Rescue on Mortality in Older Patients Undergoing Pancreatectomy.

Background: For pancreatectomy patients, mortality increases with increasing age. Our study evaluated the relative contribution of overall postoperative complications and failure to rescue rates on the observed increased mortality in older patients undergoing pancreatic resection at specialized centers.

Methods: We identified 2694 patients who underwent pancreatic resection from the American College of Surgeons' National Surgical Quality Improvement Pancreatectomy Demonstration Project at 37 high-volume centers.

Surgeon and Facility Variation in the Use of Minimally Invasive Breast Biopsy in Texas.

Objective And Background: Minimally invasive breast biopsy (MIBB) rates remain well below guideline recommendations of more than 90% and vary across geographic areas. Our aim was to determine the variation in use attributable to the surgeon and facility and determine the patient, surgeon, and facility characteristics associated with the use of MIBB.

Methods: We used 100% Texas Medicare claims data (2000-2008) to identify women older than 66 years with a breast biopsy (open or minimally invasive) and subsequent breast cancer diagnosis/operation within 1 year.

Routine drainage of the operative bed following elective distal pancreatectomy does not reduce the occurrence of complications.

Background: Routine drainage of the operative bed following elective pancreatectomy remains controversial. Data specific to distal pancreatectomy (DP) have not been examined in a multi-institutional collaborative.

Methods: Data from the American College of Surgeons-National Surgical Quality Improvement Program Pancreatectomy Demonstration Project were utilized.