Systematic Review of Integration Strategies Across the US Healthcare System: Assessment of Price, Cost, and Quality of Care.

Background: In the last 30 years, consolidation of healthcare systems in the United States has accelerated through mergers and acquisitions. We completed a systematic literature review on integration to determine if its reputation for enhancing the value of healthcare by reducing price and cost/spending and improving overall quality of care is justified.

Methods: A systematic review of the literature was completed for articles published in the United States from 1990-2024.

CRISPR/Cas9-based editing of NF-YC4 promoters yields high-protein rice and soybean.

Genome editing is a revolution in biotechnology for crop improvement with the final product lacking transgenes. However, most derived traits have been generated through edits that create gene knockouts. Our study pioneers a novel approach, utilizing gene editing to enhance gene expression by eliminating transcriptional repressor binding motifs.

Heritable gene editing in tomato through viral delivery of isopentenyl transferase and single-guide RNAs to latent axillary meristematic cells.

Realizing the full potential of genome editing for crop improvement has been slow due to inefficient methods for reagent delivery and the reliance on tissue culture for creating gene-edited plants. RNA viral vectors offer an alternative approach for delivering gene engineering reagents and bypassing the tissue culture requirement. Viruses, however, are often excluded from the shoot apical meristem, making virus-mediated gene editing inefficient in some species.

Trichorhinophalangeal Syndrome Orthopaedic Manifestations and Management: A Systematic Review.

Trichorhinophalangeal syndrome (TRPS) is an autosomal dominant genetic malformation disorder which is best characterized by both its craniofacial and skeletal abnormalities. The purpose of this paper is to identify the various orthopedic manifestations and management in patients with TRPS. A systematic search of PubMed, Ovid MEDLINE, and Cochrane Library was conducted.

Introduction to the Contemporary Assessment and Recommendations to Enhance Surgical Education and Training: Reports of the Subcommittees of the Blue Ribbon Committee II.

Objective: Provide reports of the Blue Ribbon II Subcommittees.

Background: The Blue Ribbon Committee II (BRC II) was a panel of 67 experts selected on the basis of experience and leadership in surgical education and training.

Methods: It was organized into subcommittees, each of which was asked to prepare a manuscript on their findings and recommendations.

FDG Avid Intracholecystic Papillary Neoplasm Mimicking Hepatic Metastasis in a Patient with Head-and-neck Cancer.

A 75-year-old male with head-and-neck squamous cell cancer received a staging f-18-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT) scan which showed additional focal abnormal uptake in the right hepatic lobe. The patient was treated for probable metastatic disease. Restaging FDG PET/CT scan revealed resolution of uptake in the head-and-neck and persistent focal uptake in the presumed liver metastasis.

The Blue Ribbon Committee II Report and Recommendations on Surgical Education and Training in the United States: 2024.

Objective: An expert panel made recommendations to optimize surgical education and training based on the effects of contemporary challenges.

Background: The inaugural Blue Ribbon Committee (BRC I) proposed sweeping recommendations for surgical education and training in 2004. In light of those findings, a second BRC (BRC II) was convened to make recommendations to optimize surgical training considering the current landscape in medical education.

Blue Ribbon Committee I Review: Findings and Impact.

Objective: Review the subsequent impact of recommendations made by the 2004 American Surgical Association Blue Ribbon Committee (BRC I) Report on Surgical Education.

Background: Current leaders of the American College of Surgeons and the American Surgical Association convened an expert panel to review the impact of the BRC I report and make recommendations for future improvements in surgical education.

Methods: BRC I members reviewed the 2004 recommendations in light of the current status of surgical education.

Heritable, multinucleotide deletions in plants using viral delivery of a repair exonuclease and guide RNAs.

CRISPR/Cas9-mediated mutagenesis typically results in short insertion/deletion mutations, which are often too small to disrupt the function of cis-acting regulatory elements. Here, we describe a highly efficient in planta gene editing approach called VirTREX2-HLDel that achieves heritable multinucleotide deletions in both protein-coding genes and noncoding DNA regulatory elements. VirTREX2-HLDel uses RNA viruses to deliver both the 3 prime repair exonuclease 2 (TREX2) and single-guide RNAs.

CRISPR gene editing to improve crop resistance to parasitic plants.

Parasitic plants pose a significant threat to global agriculture, causing substantial crop losses and hampering food security. In recent years, CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) gene-editing technology has emerged as a promising tool for developing resistance against various plant pathogens. Its application in combating parasitic plants, however, remains largely unexplored.

Mutator transposon insertions within maize genes often provide a novel outward reading promoter.

The highly active family of Mutator (Mu) DNA transposons has been widely used for forward and reverse genetics in maize. There are examples of Mu-suppressible alleles that result in conditional phenotypic effects based on the activity of Mu. Phenotypes from these Mu-suppressible mutations are observed in Mu-active genetic backgrounds, but absent when Mu activity is lost.

Cumulative Sum Chart as Complement to Objective Assessment of Graduating Surgical Resident Competency: An Exploratory Study.

Background: Rater-based assessment and objective assessment play an important role in evaluating residents' clinical competencies. We hypothesize that a cumulative sum (CUSUM) chart of operative time is a complement to the assessment of chief general surgery residents' competencies with ACGME Milestones, aiding residency programs' determination of graduating residents' practice readiness.

Study Design: We extracted ACGME Milestone evaluations of performance of operations and procedures (POP) and 3 objective metrics (operative time, case type, and case complexity) from 3 procedures (cholecystectomy, colectomy, and inguinal hernia) performed by 3 cohorts of residents (N = 15) during their PGY4-5.

A Variational Quantum Linear Solver Application to Discrete Finite-Element Methods.

Finite-element methods are industry standards for finding numerical solutions to partial differential equations. However, the application scale remains pivotal to the practical use of these methods, even for modern-day supercomputers. Large, multi-scale applications, for example, can be limited by their requirement of prohibitively large linear system solutions.

Programming Orientation in Liquid Crystalline Elastomers Prepared with Intra-Mesogenic Supramolecular Bonds.

The large, directional stimuli-response of aligned liquid crystalline elastomers (LCEs) could enable functional utility in robotics, medicine, consumer goods, and photonics. The alignment of LCEs has historically been realized via mechanical alignment of a two-stage reaction. Recent reports widely utilize chain extension reactions of liquid crystal monomers (LCM) to form LCEs that are subject to either surface-enforced or mechanical alignment.

Surgery Clerkship Directors' Perceptions of the COVID-19 Pandemic's Impact on Medical Student Education.

Background: This study assessed the national impact of the coronavirus disease 2019 (COVID-19) pandemic on the education of medical students assigned to surgery clerkship rotations, as reported by surgery clerkship directors (CDs).

Study Design: In the spring of 2020 and 2021, the authors surveyed 164 CDs from 144 Liaison Committee on Medical Education-accredited US medical schools about their views of the pandemic's impact on the surgery clerkship curriculum, students' experiences, outcomes, and institutional responses.

Results: Overall survey response rates, calculated as number of respondents/number of surveyed, were 44.

Cost analysis of training residents in robotic-assisted surgery.

Introduction: Use of robotic-assisted surgery is increasing, and resident involvement may lead to higher costs. We investigated whether senior resident involvement in noncomplex robotic cholecystectomy (RC) and inguinal hernia (RIH) would take more time and cost more when compared to non-robotic cholecystectomy (NRC) and inguinal hernia repair (NRIH).

Methods: We extracted surgery duration and total cost of NRC, NRIH, RC, and RIH from 7/2016 to 6/2020 with senior resident (PGY4-5) involvement.

Beyond muddy waters: Three Waters reforms required to future-proof water service delivery and protect public health in Aotearoa New Zealand.

A 2016 drinking water-related campylobacteriosis outbreak in Aotearoa New Zealand made much of an entire town sick leading to reforms colloquially called "Three Waters", which aims to improve the management and delivery of waste, storm and drinking water systems. Public discourse on the Three Waters reforms has been dominated by anti-co-governance rhetoric, concerns around privatisation and loss of local control and alternative less comprehensive reform models. This debate has drowned out the fundamental problem statement justifying the reforms, that is, the management of drinking water resources is currently: 1) demonstrably inadequate to protect public health and promote health equity; and 2) economically inefficient.

Zinc-Acetate-Amine Complexes as Precursors to ZnO and the Effect of the Amine on Nanoparticle Morphology, Size, and Photocatalytic Activity.

Zinc oxide is an environmentally friendly and readily synthesized semiconductor with many industrial applications. ZnO powders were prepared by alkali precipitation using different [Zn(acetate)(amine)] compounds to alter the particle size and aspect ratio. Slow precipitations from 95 °C solutions produced micron-scale particles with morphologies of hexagonal plates, rods, and needles, depending on the precursor used.

Critical realism methodology as a guiding framework for interdisciplinary theory enrichment: Reflections on a study of empowerment.

Philosophy of science and ontological assumptions underpin our work as scholars, explicitly, or implicitly. In this paper, we develop empowerment theory with a critical realism (CR) lens. Through the example of a study of empowerment, we examine how can it be used as a guiding paradigm for research in community psychology (CP).

Operative Coaching for General Surgery Residents: Review of Implementation Requirements.

Operative coaching offers a unique opportunity to strengthen surgery residents' skill sets and practice readiness. However, institutional organizational capacity may influence the ability to successfully implement and sustain a coaching program. This review concentrates on the implementation requirements as they relate to institutional organizational capacity to help evaluate and determine if adopting such a coaching model is feasible.