A Qualitative Study Defining Perspectives on Rurality and Surgery From Midwestern Medical Schools.

Introduction: Rural general surgery faces a crisis as more surgeons undergo fellowship training and then practice in metropolitan areas, leaving rural Americans with decreasing surgical care. This study aims to identify how hometown rurality affects medical students' current level of knowledge and potential educational gaps within their understanding of the definition, benefits, and challenges of rural general surgery to define the need for enhanced education within medical schools.

Methods: In Spring 2021, 11 Midwestern medical schools participated in an electronic survey.

Implementation of a pediatric trauma registry at a national referral center in Kenya: Utility and concern for sustainability.

Background: Pediatric trauma disproportionately affects low- and middle-income countries, particularly the pediatric trauma systems, are frequently limited. This study assessed the patterns of pediatric traumatic injuries and treatment at the only free-standing public children's hospital in East Africa as well as the implementation and sustainability of the trauma registry.

Methods: A prospective pediatric trauma registry was established at Shoe4Africa Children's Hospital (S4A) in Eldoret, Kenya.

Demographics and medical school exposures to rural health influence future practice.

Background: One-fifth of the US population lives in rural areas. A record number of rural hospitals have closed, creating increased burdens on regional centers and delays in care. This study aimed to assess medical student perceptions of rural surgery and health care, and to elucidate influential factors for future practice.

Uncovering the Overlap of Global and Domestic Rural Surgery for Medical Trainees.

Introduction: Medical trainees who participate in global rotations demonstrate improved cultural sensitivity, increased involvement in humanitarian efforts, and ability to adapt to limited resources. The global coronavirus pandemic halted global rotations for medical trainees. Domestic rural surgery (DRS) may offer a unique alternative.

Uncomplicated gastroschisis care in the US and Kenya: Treatment at two tertiary care centers.

Background: Gastroschisis is a common birth defect with < 5% mortality in high income countries, but mortality in sub Saharan Africa remains high. We sought to compare gastroschisis management strategies and patient outcomes at tertiary pediatric referral centers in the United States and Kenya.

Methods: This retrospective chart review examined uncomplicated gastroschisis patients treated at Riley Hospital for Children in Indianapolis, USA (n = 110), and Shoe4Africa Children's Hospital in Eldoret, Kenya (n = 75), from 2010 to 2018.

A population-specific reference panel for improved genotype imputation in African Americans.

There is currently a dearth of accessible whole genome sequencing (WGS) data for individuals residing in the Americas with Sub-Saharan African ancestry. We generated whole genome sequencing data at intermediate (15×) coverage for 2,294 individuals with large amounts of Sub-Saharan African ancestry, predominantly Atlantic African admixed with varying amounts of European and American ancestry. We performed extensive comparisons of variant callers, phasing algorithms, and variant filtration on these data to construct a high quality imputation panel containing data from 2,269 unrelated individuals.

Gender Differences in Insurance, Surgical Admissions and Outcomes at a Kenyan Referral Hospital.

Introduction: Gender is an important factor in determining access to healthcare resources. Women face additional barriers, especially in low- and middle-income countries. Surgical costs can be devastating, which can exacerbate engendered disparities.

Paracentral Acute Middle Maculopathy in Pregnancy.

A 31-year-old previously healthy, pregnant woman presented with acute, unilateral, painless paracentral vision loss in the left eye. The results of neuroimaging studies were normal. Hypercoagulable workup was negative, and fundus examination showed no retinal emboli and no retinal vascular abnormalities.

The association between blood pressure variability and hip or vertebral fracture risk: A population-based study.

Background: The present study evaluated the association between blood pressure variability and the risk of hip/vertebral fractures in middle aged and elderly patients.

Methods: This was a retrospective observational study of patients attending family medicine outpatient clinics, recruited from 1st January 2000 to 31st December 2003 and were followed up until 31st December 2019. Standard deviation (SD), root mean square (RMS), coefficient of variation (CV) and a variability score (defined as the number of changes in blood pressure (diastolic and systolic) of 5 mm Hg or more) were used as measures of blood pressure variability.

Use of a Novel Trigger Tool to Identify Palliative Care Needs in Surgical Patients at a National Referral Hospital in Kenya: A Pilot Study.

Addressing unmet palliative care needs in high-risk surgical patients in low- and middle-income countries must include innovative approaches to limitations in personnel and culturally acceptable assessment modalities. We assessed the utility of a novel seven-item "Step-1" trigger tool in identifying surgical patients who may benefit from palliative care. All adult patients (≥18 years) on general surgery, neurosurgery, and orthopedic surgery wards were enrolled over a four-month period.

Overview of methods for enhancing bone regeneration in distraction osteogenesis: Potential roles of biometals.

Background: Distraction osteogenesis (DO) is a functional tissue engineering approach that applies gradual mechanical traction on the bone tissues after osteotomy to stimulate bone regeneration. However, DO still has disadvantages that limit its clinical use, including long treatment duration.

Methods: Review the current methods of promoting bone formation and consolidation in DO with particular interest on biometal.

Accurate, scalable cohort variant calls using DeepVariant and GLnexus.

Motivation: Population-scale sequenced cohorts are foundational resources for genetic analyses, but processing raw reads into analysis-ready cohort-level variants remains challenging.

Results: We introduce an open-source cohort-calling method that uses the highly accurate caller DeepVariant and scalable merging tool GLnexus. Using callset quality metrics based on variant recall and precision in benchmark samples and Mendelian consistency in father-mother-child trios, we optimize the method across a range of cohort sizes, sequencing methods and sequencing depths.

Paracentral Acute Middle Maculopathy Mimicking Retrobulbar Optic Neuropathy.

A 70-year-old woman presented with acute awareness of decreased color vision in her right eye. Fundus examination and a flash electroretinography (ERG) were both normal. A multifocal ERG (mfERG) however revealed foveal depression, and thinning of inner nuclear layer was noted on macular optical coherence tomography (OCT), and a diagnosis of resolved paracentral acute middle maculopathy was made.

Transient vision loss after optic nerve sheath fenestration.

Optic nerve sheath fenestration (ONSF) is a well-known, relatively safe, and effective surgical treatment for visual loss related to papilledema. Visual loss following ONSF is uncommon but can occur from direct surgical trauma, ischemic optic neuropathy, orbital or intrasheath hemorrhage, or arterial occlusion. Transient severe (e.

Arteritic Orbital Ischemia Producing Afferent and Efferent Pupillary Defects.

A 67-year-old woman presented with acute loss of vision to no light perception (NLP), a right afferent pupillary defect, and anisocoria with a nonreactive and dilated pupil in the right eye. Fundus examination showed pallid optic disc edema and a central retinal artery occlusion (CRAO) in the right eye. A temporal artery biopsy showed giant cell arteritis (GCA).

"Testing is Healthy" TimePlay campaign: Evaluation of sexual health promotion gamification intervention targeting young adults.

Objectives: The objectives of the study were to 1) describe the implementation of the "Testing is Healthy" campaign in four locations in British Columbia (BC) and 2) report process evaluation indicators for the campaign.

Participants: Young adults ages 20-29 years, the age group with the highest reported rates of chlamydia and gonorrhea in BC.

Settings: Movie theatres located in Langley, Burnaby, Coquitlam and Surrey, which are communities served by the Fraser Health Authority (FHA) in BC.

Necrotizing Fasciitis of the Periorbital Region Complicated by Combined Central Retinal Artery Occlusion, Central Retinal Vein Occlusion, and Posterior Ciliary Occlusion.

A 50 year-old man on immunosuppressive agents presented with left eye vision loss, periorbital swelling, pain, and ophthalmoplegia. The patient was clinically found to have a central retinal artery and vein occlusion. A CT scan was performed which demonstrated intraorbital fat stranding, however the patient lacked sinus disease.