Experimental evolution of for caffeine tolerance alters multidrug resistance and TOR signaling pathways.

Caffeine is a natural compound that inhibits the major cellular signaling regulator TOR, leading to widespread effects including growth inhibition. yeast can adapt to tolerate high concentrations of caffeine in coffee and cacao fermentations and in experimental systems. While many factors affecting caffeine tolerance and TOR signaling have been identified, further characterization of their interactions and regulation remain to be studied.

yEvo: A modular eukaryotic genetics and evolution research experience for high school students.

The resources for carrying out and analyzing microbial evolution experiments have become more accessible, making it possible to expand these studies beyond the research laboratory and into the classroom. We developed five connected, standards-aligned yeast evolution laboratory modules, called "yEvo," for high school students. The modules enable students to take agency in answering open-ended research questions.

Caffeine-tolerant mutations selected through an at-home yeast experimental evolution teaching lab.

yEvo is a curriculum for high school students centered around evolution experiments in . To adapt the curriculum for remote instruction, we created a new protocol to evolve non-engineered yeast in the presence of caffeine. Evolved strains had increased caffeine tolerance and distinct colony morphologies.

Caffeine-tolerant mutations selected through an at-home yeast experimental evolution teaching lab.

yEvo is a curriculum for high school students centered around evolution experiments in . To adapt the curriculum for remote instruction, we created a new protocol to evolve non-GMO yeast in the presence of caffeine. Evolved strains had increased caffeine tolerance and distinct colony morphologies.

Leadership proficiency in surgery: lessons from the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has accentuated the importance of leadership training for health care professionals, particularly surgeons. Surgeons are expected to lead and thrive in multidisciplinary teams. There is, however, a critical gap in teaching residents about fundamental leadership principles, such as developing productive and vision-driven teams, conflict resolution and emotional intelligence.

Rapid Ground Transport of Trauma Patients: A Moderate Distance From Trauma Center Improves Survival.

Background: There is debate within the emergency medical services (EMS) community over the value of calling a helicopter for trauma patients within a moderate distance/<45 min, of a trauma center. Helicopter EMS (HEMS) generally have a wider scope and more advanced training than the ground EMS (GEMS). GEMS, on the other hand, have the benefit of being able to immediately initiate rapid transport to the trauma center without the delay involved with HEMS flying to the scene, landing, and assuming patient care.

Energy-triggered drug release from polymer nanoparticles for orthopedic applications.

Sequestra, present in many cancers and orthopedic infections, provide a safe harbor for the development of drug resistance. In the face of burgeoning drug resistance, the importance of nanoscale, microenvironment-triggered drug delivery cannot be overestimated. Such strategies may preserve pharmaceutical efficacy and significantly alter the etiology of many orthopedic diseases.

Up-front hepatic resection for metastatic colorectal cancer results in favorable long-term survival.

Background: Hepatic metastasis from colorectal cancer (CRC) is best managed with a multimodal approach; however, the optimal timing of liver resection in relation to administration of perioperative chemotherapy remains unclear. Our strategy has been to offer up-front liver resection for patients with resectable hepatic metastases, followed by post-liver resection chemotherapy. We report the outcomes of patients based on this surgical approach.

Changes in safety attitude and relationship to decreased postoperative morbidity and mortality following implementation of a checklist-based surgical safety intervention.

Objectives: To assess the relationship between changes in clinician attitude and changes in postoperative outcomes following a checklist-based surgical safety intervention.

Design: Pre- and post intervention survey.

Setting: Eight hospitals participating in a trial of a WHO surgical safety checklist.

A surgical safety checklist to reduce morbidity and mortality in a global population.

Background: Surgery has become an integral part of global health care, with an estimated 234 million operations performed yearly. Surgical complications are common and often preventable. We hypothesized that a program to implement a 19-item surgical safety checklist designed to improve team communication and consistency of care would reduce complications and deaths associated with surgery.

What surgeons tell their patients about the intraoperative role of residents: a qualitative study.

Background: The issue of residents operating and disclosure to patients about this have not been explored from staff surgeons' perspectives.

Methods: A preliminary survey was sent to all active surgeons at the University of Toronto. A qualitative interview study followed.

Water-jet dissection for parenchymal division during hepatectomy.

Background: High-pressure water-jet dissection was originally developed for industry where ultra-precise cutting and engraving were desirable. This technology has been adapted for medical applications with favorable results, but little is understood about its performance in hepatic resections. Blood loss may be limited by the thin laminar liquid-jet effect that provides precise, controllable, tissue-selective dissection with excellent visualization and minimal trauma to surrounding fibrous structures.

Recurrent pyogenic cholangitis with hepatolithiasis--the role of surgical therapy in North America.

Purpose: To determine role of surgical intervention for Recurrent Pyogenic Cholangitis with hepatolithiasis at a North American hepatobiliary center.

Methods: Retrospective analysis of 42 patients presenting between 1986 and 2005.

Results: Mean age is 54.

Focal chronic pancreatitis mimicking pancreatic head carcinoma: are there suggestive features on ultrasound?

Objective: Painless jaundice is one of the most common presentations of pancreatic head cancer. Chronic pancreatitis can also occasionally present with a mass or mass-like process in the pancreatic head, with the subsequent development of jaundice. In this retrospective review, we evaluate the clinical and imaging features of 22 patients presenting with painless jaundice, initially thought to have pancreatic head cancer and ultimately proven to have chronic focal pancreatitis, to determine whether there are any features on cross-sectional imaging to suggest the correct diagnosis.

Recurrence after liver resection for hepatocellular carcinoma: risk factors, treatment, and outcomes.

Background: Tumor recurrence remains the major cause of death after curative resection for hepatocellular carcinoma (HCC). The purpose of this study was to identify risk factors for the recurrence of HCC and to examine long-term outcomes after resection.

Methods: From July 1992 to July 2004, 193 consecutive patients who underwent hepatic resection as primary therapy with curative intent for HCC were included in this single-center analysis.

The business case for patient safety.

The leadership team at University Health Network describes why it decided to pursue a new information technology initiative to substantially reduce human and system errors and omissions associated with medication management.

Impact of regional lymph node evaluation in staging patients with periampullary tumors.

Background: Two distinct lymph nodes reproducibly assessed by computed tomography for the evaluation of periampullary tumors are the common bile duct (CBD) node and the gastroduodenal artery (GDA) node. We examined whether radiographical enlargement of either lymph node predicts tumor resectability, nodal metastasis, or patient survival.

Methods: Ninety-four consecutive patients underwent attempted curative resection of periampullary tumors between September 2001 and June 2003.

Chemotherapy for colorectal cancer prior to liver resection for colorectal cancer hepatic metastases does not adversely affect peri-operative outcomes.

Background: Systemic chemotherapy is being used increasingly in patients with colorectal cancer. The effects of prior systemic adjuvant or palliative chemotherapy on morbidity following hepatic resection for metastases are not well defined.

Objectives: To assess the peri-operative impact of systemic chemotherapy on liver resection for colorectal cancer hepatic metastases.

Survival after hepatic resection for colorectal metastases: a 10-year experience.

Background: Metastatic colorectal cancer is a major cause of cancer death in North America. Hepatic resection offers the potential for cure in selected patients. We report the long-term outcomes of patients who underwent hepatic resection for colorectal metastases over a 10-year period at a single hepatobiliary surgical oncology center.

Surgical resection of hepatic and pulmonary metastases from colorectal carcinoma.

Background: Patients with hepatic and pulmonary metastases from colorectal cancer (CRC) may benefit from aggressive surgical therapy. We examined the longterm outcomes of patients who underwent both lung and liver resections for colorectal metastases over a 10-year period.

Study Design: Four hundred twenty-three hepatectomies were performed for metastatic CRC between 1992 and 2002 at two university-affiliated hospitals.