Teaching Atraumatic Soft Tissue Handling in the Simulation Laboratory: Development of a Novel Training System.

Atraumatic soft issue handling is essential for optimal wound healing. Simulation is a safe and effective way to improve surgical skills outside the operating room. Our primary aim was the development of a pressure-sensing forceps that measures the force applied to a given tissue and provides real-time biofeedback.

Point mutations in Arf1 reveal cooperative effects of the N-terminal extension and myristate for GTPase-activating protein catalytic activity.

The ADP-ribosylation factors (Arfs) constitute a family of small GTPases within the Ras superfamily, with a distinguishing structural feature of a hypervariable N-terminal extension of the G domain modified with myristate. Arf proteins, including Arf1, have roles in membrane trafficking and cytoskeletal dynamics. While screening for Arf1:small molecule co-crystals, we serendipitously solved the crystal structure of the non-myristoylated engineered mutation [L8K]Arf1 in complex with a GDP analogue.

Impact of Intraoperative Hypothermia on Incidence of Infection in Implant-Based Breast Reconstruction.

Background: Infection following implant-based breast reconstruction can lead to devastating complications. Risk factors for infection include smoking, diabetes, and obesity. Intraoperative hypothermia may represent another modifiable risk factor.

Impact of Intraoperative Hypothermia on Autologous Breast Reconstruction.

Objective: Studies have identified perioperative hypothermia as a risk factor for impaired wound healing, increased hospital length of stay, and surgical site infection. This study examines the effect of intraoperative hypothermia on postoperative outcomes in autologous microvascular free flap breast reconstruction.

Methods: This was a retrospective review of 55 patients who experienced intraoperative hypothermia, defined as less than 35.

One Size Does Not Fit All; Patient Preference for Breast Reconstruction.

Background: A myriad of patient education modalities for breast reconstruction exist, although the optimal tools for patient education remain undetermined. The aim of this study is to determine patient preferences for breast reconstruction education modalities based on demographic variables.

Methods: A prospective observational study at a tertiary care university health system was conducted between November 2020 and May 2021.

Framing and Policymaker Evaluations of the Opioid Crisis.

Several extremely influential theories, including the multiple streams approach and punctuated equilibrium theory, predict that dramatic policy change occurs when problems are reframed. However, there is little direct evidence of how framing messages influence policymaker attitudes, perceptions, and behaviors. In an online survey of local policymakers in Illinois, we find that different media frames of the opiate epidemic influence policymaker attitudes and attributions of responsibility.

The Impact of Preoperative Breast Volume on Development of Mastectomy Skin Flap Necrosis in Immediate Breast Reconstruction.

Background: Mastectomy skin flap necrosis (MSFN) can significantly impact outcome after immediate breast reconstruction. Several techniques exist to predict MSFN, but these may require additional testing and information, and they are often not available before surgery. We aim to identify whether breast volume, as calculated from preoperative mammography, can be used as a preoperative predictor of MSFN.

It's not all White: Implicit Racial Bias in Imagery Used in Plastic Surgery Resident Education.

Objective: Plastic surgery education relies heavily on images featuring patient skin tone; while images can be useful representations, it is highly susceptible to implicit bias, a known contributor to healthcare disparities. Using skin tone as a proxy, this study evaluates patient representation in images used in the American Society of Plastic Surgery Resident Education Curriculum.

Design: Color photographs, graphics, and videos featured in the American Society of Plastic Surgery "Course Materials" for each module were categorized using the Fitzpatrick scale (I-II, III-IV, or V-VI) by six reviewers.

Utilizing a Comprehensive Wound Care Team to Lower Hospital-Acquired Pressure Injuries in an Academic Public Hospital: A Retrospective Cohort Study.

Purpose: Hospital-acquired pressure injuries (HAPIs) have significant impacts on patient morbidity and mortality, with approximately 2.5 million patients treated for pressure-related injuries annually.1 This study aimed to describe the influence of a comprehensive wound care team on HAPIs over an 8-year period.

Breast Implants: A Historical Review With Implications for Diagnosis and Modern Surgical Planning.

Modern breast surgery was first introduced in the United States in 1962 with the use of silicone gel-filled breast implants. Over the past 6 decades, development of breast implants has been challenged by a variety of influencers including aesthetic appeal in shape, texture, and material; challenges in managing outcomes such as contracture, disease, and rupture; and public perception of risks associated with implants. In 1992, silicone breast prostheses were banned by the US Food and Drug Administration with exception for use in breast reconstruction, congenital deformities, or to replace existing implants.

Analysis of Pediatric Dog Bite Injuries at a Level 1 Trauma Center Over 10 Years.

Background: Dog bite injuries cause significant preventable patient morbidity and health care expenditure in children. This study aimed to characterize the patient and healthcare burden related to pediatric dog bite injuries at a level 1 trauma center.

Methods: This is a retrospective review of 356 pediatric patients who presented to Virginia Commonwealth University Pediatric Emergency Department between July 2007 and August 2017 after sustaining dog bite injuries.

A 15-Year Review of Iatrogenic Burn Injuries in an Academic Public Hospital.

Hospital-acquired burn injuries can result in increased length of hospitalization, costs of stay, and potential for additional procedures. The aim of this study is to describe iatrogenic burn injuries over a 15-year period at an academic public hospital system. Data was collected from January 2004 to June 2019.

Assessing Readability of Patient Education Materials on Breast Reconstruction by Major US Academic Hospitals as Compared With Nonacademic Sites.

Purpose: Women undergoing postmastectomy breast reconstruction face many complex choices. A myriad of online patient education materials exist to assist in decision making. Understanding of these materials, termed health literacy, affects surgical decision making and outcomes.

Relationship of Absolute and Relative Lower-Body Strength to Predictors of Athletic Performance in Collegiate Women Soccer Players.

The purpose of this study was to investigate the relationships between absolute and relative lower-body strength on predictors of athletic performance among Division II collegiate women's soccer players. Archived pre-season testing data for seventeen ( = 17) female National Collegiate Athletics Association (NCAA) Division II soccer players were analyzed, including: vertical jump, 3RM back squat, 505-agility, modified T-test, 10 m and 30 m sprint, and 20 m multistage fitness test (20 m MSFT). Relative strength was calculated based on the estimated 1RM back squat divided by the athlete's body mass.

Patent foramen ovale and neurologic events in patients undergoing liver transplantation.

Background: Patent foramen ovale (PFO) is present in approximately 20% of individuals. During liver transplantation (LT), intra-operative transesophageal echocardiography can observe transient intra-cardiac shunting of atheromatous debris via a PFO. Closure of PFOs prior to LT has thus been suggested as a potential treatment to reduce peri-operative cerebral vascular accident (CVA).

Human brain metastatic stroma attracts breast cancer cells via chemokines CXCL16 and CXCL12.

The tumor microenvironment is composed of heterogeneous populations of cells, including cancer, immune, and stromal cells. Progression of tumor growth and initiation of metastasis is critically dependent on the reciprocal interactions between cancer cells and stroma. Through RNA-Seq and protein analyses, we found that cancer-associated fibroblasts derived from human breast cancer brain metastasis express significantly higher levels of chemokines CXCL12 and CXCL16 than fibroblasts from primary breast tumors or normal breast.

Accumulation of non-outer segment proteins in the outer segment underlies photoreceptor degeneration in Bardet-Biedl syndrome.

Compartmentalization and polarized protein trafficking are essential for many cellular functions. The photoreceptor outer segment (OS) is a sensory compartment specialized for phototransduction, and it shares many features with primary cilia. As expected, mutations disrupting protein trafficking to cilia often disrupt protein trafficking to the OS and cause photoreceptor degeneration.

Antigen-specific inhibition of high-avidity T cell target lysis by low-avidity T cells via trogocytosis.

Current vaccine conditions predominantly elicit low-avidity cytotoxic T lymphocytes (CTLs), which are non-tumor-cytolytic but indistinguishable by tetramer staining or enzyme-linked immunospot from high-avidity CTLs. Using CTL clones of high or low avidity for melanoma antigens, we show that low-avidity CTLs can inhibit tumor lysis by high-avidity CTLs in an antigen-specific manner. This phenomenon operates in vivo: high-avidity CTLs control tumor growth in animals but not in combination with low-avidity CTLs specific for the same antigen.

Antiretroviral drugs induce oxidative stress and neuronal damage in the central nervous system.

HIV-associated neurocognitive disorder (HAND), characterized by a wide spectrum of behavioral, cognitive, and motor dysfunctions, continues to affect approximately 50 % of HIV(+) patients despite the success of combination antiretroviral drug therapy (cART) in the periphery. Of note, potential toxicity of antiretroviral drugs in the central nervous system (CNS) remains remarkably underexplored and may contribute to the persistence of HAND in the cART era. Previous studies have shown antiretrovirals (ARVs) to be neurotoxic in the peripheral nervous system in vivo and in peripheral neurons in vitro.

Gene expression profiling of flaxseed in mouse lung tissues-modulation of toxicologically relevant genes.

Background: Flaxseed (FS), a nutritional supplement consisting mainly of omega-3 fatty acids and lignan phenolics has potent anti-inflammatory, anti-fibrotic and antioxidant properties. The usefulness of flaxseed as an alternative and complimentary treatment option has been known since ancient times. We have shown that dietary FS supplementation ameliorates oxidative stress and inflammation in experimental models of acute and chronic lung injury in mice resulting from diverse toxicants.

Advanced glycation end products on stored red blood cells increase endothelial reactive oxygen species generation through interaction with receptor for advanced glycation end products.

Background: Recent evidence suggests that storage-induced alterations of the red blood cell (RBC) are associated with adverse consequences in susceptible hosts. As RBCs have been shown to form advanced glycation end products (AGEs) after increased oxidative stress and under pathologic conditions, we examined whether stored RBCs undergo modification with the specific AGE N-(carboxymethyl)lysine (N(ε) -CML) during standard blood banking conditions.

Study Design And Methods: Purified, fresh RBCs from volunteers were compared to stored RBCs (35-42 days old) obtained from the blood bank.

Robotic fourth-arm enucleation of an esophageal leiomyoma and review of literature.

Esophageal leiomyomas are resected in symptomatic and/or malignancy-suspicious cases. Traditionally, they have been removed by laparotomy or thoracotomy and more recently by thoracoscopy and laparoscopy. Mucosal injury is reported as high as 7% of cases but may be higher in unreported general practice.