Impact of 2023 Ventral Hernia Repair CPT Code Changes on Work Relative Value Units in a Tertiary Hernia Referral Center.

Background: CPT codes for ventral hernia repair (VHR) changed in January 2023 to address the heterogeneity of procedures with a concomitant shift from a 90-day to a 0-day global period. This study reviews a tertiary referral center's experience with hernia coding comparing the work relative value units (wRVUs) generated for ventral hernia repair pre-2023 compared to post-2023.

Study Design: CPT codes were analyzed for patients undergoing open or laparoscopic VHR before updates to the CPT hernia codes (January 2022-September 2022) and following CPT change (January 2023-September 2023).

Holistic Review in Applicant Selection: A Scoping Review.

Purpose: To avoid overreliance on metrics and better identify candidates who add value to the learning environment, some medical schools and residency programs have begun using holistic review for screening and selection, but limited data support or refute this use. This scoping review examines holistic review definitions and practice in medical education, summarizes research findings, and identifies gaps for future research.

Method: The authors searched 7 databases using the keywords holistic, attributes, mission-based, mission-centric , and socially accountable for articles on holistic review within undergraduate medical education (UME) and graduate medical education (GME) published from database inception through July 5, 2024.

Perioperative outcomes after hepatectomy for hepatocellular carcinoma among patients with cirrhosis, fatty liver disease, and clinically normal livers.

Introduction: Despite superior outcomes with liver transplantation, cirrhotic patients with HCC may turn to other forms of definitive treatment. To understand perioperative outcomes, we examined perioperative mortality and major morbidity after hepatectomy for HCC among cirrhotic and non-cirrhotic patients.

Method: ology: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database was queried for liver resection for HCC.

Outcomes associated with absent blood product utilization in Jehovah's witness patients compared to the standard of care in cardiac surgery: A ten-year experience.

Introduction: For Jehovah's Witness (JW) patients requiring cardiac surgery, various strategies such as preoperative use of erythropoietin stimulating agents (ESAs), intravenous iron (IVI), and non-pharmacologic interventions have emerged to prevent complications from blood loss given transfusion is not acceptable in this population.

Methods: Retrospective case-control of cardiac surgeries performed by the same surgeon between 1/1/2011 and 8/30/2021. JW patients were matched to non-JW who received blood products and non-JW who did not receive blood products on a 1:2:2 basis.

Diversity in Hand Surgery Leadership: The Impact of Mentorship and Bias.

Background: Diversity in leadership drives innovation. However, underrepresented minorities may face barriers. The aim of this study is to understand the impact of gender and race on the experience of leaders in hand surgery.

Predictors of postoperative opioid use in ventral and incisional hernia repair.

Background: One in two ventral and incisional hernia repair (VIHR) patients have preoperative opioid prescription within a year before procedure. The study's aim was to investigate risk factors of increased postoperative prescription filling in patients with or without preoperative opioid prescription.

Methods: VIHR cases from 2013 to 2017 were reviewed.

Prescription opioid use increases resource utilization following ventral hernia repair.

Background: Previous studies showed that preoperative opioid use is associated with increased postoperative opioid use and surgical site infection (SSI) in patients undergoing ventral hernia repair (VHR). Orthopedic surgery literature cites increased resource utilization with opioid use. This study aimed to determine the effect of preoperative opioid use on resource utilization after open VHR.

The motivating effect of monetary over psychological incentives is stronger in WEIRD cultures.

Motivating effortful behaviour is a problem employers, governments and nonprofits face globally. However, most studies on motivation are done in Western, educated, industrialized, rich and democratic (WEIRD) cultures. We compared how hard people in six countries worked in response to monetary incentives versus psychological motivators, such as competing with or helping others.

Comparative long-term effectiveness between ventral hernia repairs with biosynthetic and synthetic mesh.

Background: Debate exists regarding the most appropriate type of mesh to use in ventral hernia repair (VHR). Meshes are broadly categorized as synthetic or biologic, each mesh with individual advantages and disadvantages. More recently developed biosynthetic mesh has characteristics of both mesh types.

Deconstructing stereotypes: Stature, match-playing time, and performance in elite Women's World Cup soccer.

Recruiting companies recommend elite female soccer players be ≥165 cm (5'5″) in stature. This study investigated if stature limits match-playing time and performance in elite World Cup soccer among players, positions, and countries. We hypothesized stature would not affect match-playing time or performance.

Surgical Site Infections in Colorectal Resections: What is the Cost?

Introduction: Although surgical site infections (SSIs) associated with colectomy are tracked by the National Healthcare Safety Network/Center for Disease Control, untracked codes, mainly related to patients undergoing proctectomy, are not. These untracked codes are performed less often yet they may be at a greater risk of SSI due to their greater complexity. Determining the impact and predictors of SSI are critical in the development of quality improvement initiatives.

Opioid Use After Colorectal Resection: Identifying Preoperative Risk Factors for Postoperative Use.

Introduction: Appropriate prescribing practices are imperative to ensure adequate pain control, without excess opioid dispensing across colorectal patients.

Methods: National Surgical Quality Improvement Program, Kentucky All Scheduled Prescription Electronic Reporting, and patient charts were queried to complete a retrospective study of elective colorectal resections, performed by a fellowship-trained colorectal surgeon, from January 2013 to December 2020. Opioid use at 14 d and 30 d posthospital discharge converted into morphine milligram equivalents (MMEs) were analyzed and compared across preadmission and inpatient factors.

Variability in hospital costs for short stay emergent laparoscopic appendectomy.

Background: Acute care surgery (ACS) diagnoses including appendicitis comprise 20% of inpatient admissions in the U.S. and 25% of hospital costs.

A comparison of NSQIP and CESQIP in data quality and ability to predict thyroidectomy outcomes.

Background: The Collaborative Endocrine Surgery Quality Improvement Program tracks thyroidectomy outcomes with self-reported data, whereas the National Surgical Quality Improvement Program uses professional abstractors. We compare completeness and predictive ability of these databases at a single-center and national level.

Method: Data consistency in the Collaborative Endocrine Surgery Quality Improvement Program and the National Surgical Quality Improvement Program at a single institution (2013-2020) was evaluated using McNemar's test.

Ethnic and Racial Differences in Ratings in the Medical Student Standardized Letters of Evaluation (SLOE).

Background: The Standardized Letter of Evaluation (SLOE) stratifies the assessment of emergency medicine (EM) bound medical applicants. However, bias in SLOE, particularly regarding race and ethnicity, is an underexplored area.

Objective: This study aims to assess whether underrepresented in medicine (UIM) and non-UIM applicants are rated differently in SLOE components.

Predictors of Liver Failure in Non-Cirrhotic Patients Undergoing Hepatectomy.

Background: Post-hepatectomy liver failure (PHLF) is associated with high mortality following liver resection. There have been limited studies evaluating predictors of PHLF and clinically significant PHLF in non-cirrhotic patients.

Methods: This was a retrospective cohort study using the National Surgical Quality Improvement Program database (NSQIP) to evaluate 8,093 non-cirrhotic patients undergoing hepatectomy from 2014 to 2018.

Trends of Pandemic Parenting in Medical Academia.

Introduction: The pandemic has been difficult on physicians, with two fifths of doctors in one survey reporting that their mental health is now worse than before the pandemic. It is likely that a significant proportion of these physicians are parents of children necessitating childcare, as approximately 32% of the US workforce has someone in their household under the age of 14. We sought to study the impact of the coronavirus 2019 (COVID-19) pandemic on physician parents in academia.

Treatment of bone loss in CKD5D: Better survival in patients with non-high bone turnover.

67% of CKD5D patients have low bone mass and present with high (HTO) or non-high (N-HTO) bone turnover. HTO has excessive resorption calling for anti-resorbers, while in N-HTO, anabolic therapy appears preferable. There are no data on this tailored approach.

New Cancer-Related Symptoms Predict Recurrence in CA19-9 Non-Expressers After Resection of Pancreatic Ductal Adenocarcinoma.

Introduction: CA19-9 elevation has been reported to predict recurrence after resection of pancreatic ductal adenocarcinoma (PDAC), although only two-thirds of patients are expressers. Preoperatively, cancer-related symptoms predict outcome; however, it is unknown whether symptoms predict recurrence during surveillance, particularly for CA19-9 non-expressers.

Methods: Patients undergoing resection of PDAC at our institution from 2012 to 21 (n = 165) were retrospectively reviewed for CA19-9 and symptoms, which were correlated with recurrence-free survival (RFS).

Pivotal voting: The opportunity to tip group decisions skews juries and other voting outcomes.

Many important social and policy decisions are made by small groups of people (e.g., juries, college admissions officers, or corporate boards) with the hope that a collective process will yield better and fairer decisions.

Prevalence of low bone formation in untreated patients with osteoporosis.

Background: Osteoporosis treatment usually starts with an antiresorber and switches to an anabolic agent if it fails. It is known that suppressing bone resorption also results in reduced bone formation. In addition, patients with prior treatment with antiresorbers may have reduced response to subsequent anabolic treatment.

Formation of colloidal chains and driven clusters with optical binding.

We study the effects of the optical binding force on wavelength sized colloidal particles free to move in a counter-propagating beam. This work is motivated by the concept of using optical binding to direct the assembly of large numbers of colloidal particles; previous work has used small numbers of particles and/or 1D or 2D restricted geometries. Utilizing a novel experimental scheme, we describe the general static and dynamic self-organization behaviors for 20-100 particles free to move in 3-dimensional space.