Fellow perceptions of robotic surgery preparedness for fellowship.

Introduction: Many surgical fellowship programs incorporate robotic surgery, yet not all residency programs offer robotic training for residents. Given the variability of pre-fellowship robotic exposure, the goal of this study was to explore whether standardized robotic skills assessment would be useful to fellows at the start of their training.

Methods: In partnership with the Fellowship Council, we surveyed current fellows of accredited Thoracic, Colorectal, HPB, and Advanced GI/MIS/Bariatrics/Foregut Fellowship programs.

Patients report significant improvement in quality of life following hiatal hernia repair-despite recurrence.

Background: Hiatal hernia (HH) repairs have been associated with high recurrence rates. This study aimed to investigate if changes in patient's self-reported GERD health-related quality of life (HRQL) scores over time are associated with long-term surgical outcomes.

Methods: Retrospective chart reviews were conducted on all patients who had laparoscopic or robotic HH repairs between 2018 and 2022 at a tertiary care center.

Evolving Medical Student Experiences in the Surgery Clerkship: A New Generation.

Background: The surgery clerkship has a powerful impact on medical students' attitudes toward surgery. The primary aim of this study was to identify factors that influence current medical student experiences during the surgery clerkship and discern if they have shifted following the COVID pandemic and with a new generation of "Zillennial" students.

Materials And Methods: We conducted a qualitative content analysis of medical student surgery clerkship evaluations from 2018 to 2022 at three clinical training sites of our medical school (n = 596).

AI Versus MD: Evaluating the surgical decision-making accuracy of ChatGPT-4.

Background: ChatGPT-4 is a large language model with possible applications to surgery education The aim of this study was to investigate the accuracy of ChatGPT-4's surgical decision-making compared with general surgery residents and attending surgeons.

Methods: Five clinical scenarios were created from actual patient data based on common general surgery diagnoses. Scripts were developed to sequentially provide clinical information and ask decision-making questions.

A second chance for a new heart? The role of metabolic and bariatric surgery in patients with end-stage heart failure.

Background: Obesity is an independent risk factor for heart failure (HF). Substantial weight loss has been shown to reverse obesity-related cardiomyopathy. This study aimed to report our institution's experience with laparoscopic sleeve gastrectomy (LSG) in patients with morbid obesity and end-stage HF.

Hiatal hernia reporting: time to remove subjectivity?

Introduction: The size of a hiatal hernia (HH) is a key determinant of the approach for surgical repair. However, endoscopists will often utilize subjective terms, such as "small," "medium," and "large," without any standardized objective correlations. The aim of this study was to identify HHs described using objective axial length measurements versus subjective size allocations and compare them to their corresponding manometry and barium swallow studies.

Characterizing the Role of Surgical Vice Chair of Education: Stakeholder Needs and Current Practices.

Introduction: The role of a Department of Surgery (DoS) Vice Chair of Education (VCE) is a relatively new position intended to address the many changes and initiatives in medical education. The primary responsibilities and functions of a surgical VCE are not well described in the literature. This study examines the perceptions of stakeholders and current VCEs to develop a newly established position of VCE within an academic DoS.

Preclinical Immersion Experiences Improve Medical Student Perceptions of Surgery.

Introduction: Medical students historically receive little to no preclinical exposure to surgery and surgical subspecialties. As a result, by the time they reach their clinical clerkship time, students often have already found interest in other specialties. The goal of this study is to utilize the knowledge to action (KTA) implementation framework to design and refine a clinical immersion experience during the second year of medical school.

Successful virtual interviews for surgery residents.

The SARS-CoV-2 pandemic resulted in surgical residency and fellowship interviews shifting to a virtual, web-based format. Although virtual interviews have important benefits, this change also brought about new challenges for applicants, including a new interview etiquette and potential difficulty in evaluating and discriminating between programs. The aim of this article is to provide applicants with guidance for every step of their interview process so that they can confidently put forth their strongest performance.

Does retrieval bag use during laparoscopic appendectomy reduce postoperative infection?

Background: Appendectomy is the most commonly performed emergency operation in the United States, with approximately 370,000 patients undergoing the procedure every year. Although laparoscopic appendectomy is associated with decreased complications when compared with open appendectomy, the risk for infectious complications, including surgical site infection, intra-abdominal abscess, and sepsis, remains a significant source of postoperative morbidity and health care cost. The goal of this study is to determine whether the appendix retrieval technique during laparoscopic appendectomy affects risk of infectious complications.

Association of Low Vitamin D Levels With Noninfectious Anterior Uveitis.

Importance: Vitamin D plays an important role in both the innate and adaptive immune systems. It has been shown to contribute to the etiology of T-cell-mediated autoimmune diseases through the upregulation of type 2 anti-inflammatory T helper cells and the suppression of type 1 T helper cells. Noninfectious uveitis is postulated to be caused by immune dysfunction.

Mcl-1 protects prostate cancer cells from cell death mediated by chemotherapy-induced DNA damage.

The anti-apoptotic protein Mcl-1 is highly expressed in castration-resistant prostate cancer (CRPC), resulting in resistance to apoptosis and association with poor prognosis. Although predominantly localized in the cytoplasm, there is evidence that Mcl-1 exhibits nuclear localization where it is thought to protect against DNA damage-induced cell death. The role of Mcl-1 in mediating resistance to chemotherapy-induced DNA damage in prostate cancer (PCa) is not known.

Betulinic acid selectively increases protein degradation and enhances prostate cancer-specific apoptosis: possible role for inhibition of deubiquitinase activity.

Inhibition of the ubiquitin-proteasome system (UPS) of protein degradation is a valid anti-cancer strategy and has led to the approval of bortezomib for the treatment of multiple myeloma. However, the alternative approach of enhancing the degradation of oncoproteins that are frequently overexpressed in cancers is less developed. Betulinic acid (BA) is a plant-derived small molecule that can increase apoptosis specifically in cancer but not in normal cells, making it an attractive anti-cancer agent.

Prospective assessment of ictal behavior using the revised Responsiveness in Epilepsy Scale (RES-II).

Impaired consciousness in epilepsy has a significant negative impact on patients' quality of life yet is difficult to study objectively. Here, we develop an improved prospective Responsiveness in Epilepsy Scale-II (RES-II) and report initial results compared with the earlier version of the scale (RES). The RES-II is simpler to administer and includes both verbal and non-verbal test items.