A Narrative Review Investigating Practices and Disparities in Child Abuse Amongst United States Pediatric Trauma Patients & Associated Outcomes.

Introduction: Although non-accidental trauma continues to be a leading cause of morbidity and mortality among children in the United States, the underlying factors leading to NAT are not well characterized. We aim to review reporting practices, clinical outcomes, and associated disparities among pediatric trauma patients experiencing NAT.

Methods: A literature search utilizing PubMed, Google Scholar, EMBASE, ProQuest, and Cochrane was conducted from database inception until April 6, 2023.

Cultivating emotional intelligence in general surgery residents through a patient-centered experience.

Background: Emotional intelligence (EI) can decrease physician burnout. EI and burnout were assessed in surgical residents through participation in Patient-Centric Resident Conferences (PCRCs), which incorporated patients in resident education. We hypothesized PCRCs would improve EI and reduce burnout.

Evaluating the effectiveness and outcomes associated with direct peritoneal resuscitation in damage control surgery patients with and without hemorrhagic shock.

Introduction: This narrative review aims to evaluate the efficacy of adjunct direct peritoneal resuscitation (DPR) in the treatment of adult damage control surgery (DCS) patients both with and without hemorrhagic shock, and its impact on associated outcomes.

Methods: PubMed, Google Scholar, EMBASE, ProQuest, and Cochrane were searched for relevant articles published through April 13th, 2023. Studies assessing the utilization of DPR in adult DCS patients were included.

Adverse Events Associated With Disparity Between Patients' BMI and Operating Table Size-A Need for Improved Surgical Innovations.

Background: The lack of proper equipment to accommodate patients with high BMI can jeopardize the safety of the patients and medical staff. In this review, we aim to discuss the availability of obesity accommodations in the operating room, along with its impact, implications, and future recommendations.

Methods: Four databases were searched for articles pertaining to surgical table dimensions and the implications for safety, with a special focus on patients with larger BMIs.

Trends in disparities research on trauma and acute care surgery outcomes: A 10-year systematic review of articles published in The Journal of Trauma and Acute Care Surgery.

Abstract: This is a 10-year review of The Journal of Trauma and Acute Care Surgery (JTACS) literature related to health care disparities, health care inequities, and patient outcomes. A retrospective review of articles published in JTACS between January 1, 2013, and July 15, 2022, was performed. Articles screened included both adult and pediatric trauma populations.

Breaking barriers and advancing diversity, equity, and inclusion in trauma and acute care surgery: A current perspective.

Abstract: The importance of diversity, equity, and inclusion (DEI) in trauma and acute care surgery (ACS) has become increasingly apparent in the field of medicine. Despite the growing diversity of the patient population, the surgical specialty has traditionally been dominated by White males. This involves increasing the representation of diverse individuals in leadership positions, professional societies, scholarships, graduate education, and practicing physicians.

CAB versus ABC approach for resuscitation of patients following traumatic injury: Toward improving patient safety and survival.

Introduction: Though a circulation-airway-breathing (CAB) resuscitation sequence is now widely accepted in administering CPR over the airway-breathing-circulation (ABC) sequence following cardiac arrest, current evidence and guidelines vary considerably for complex polytraumas, with some prioritizing management of the airway and others advocating for initial treatment of hemorrhage. This review aims to evaluate existing literature comparing ABC and CAB resuscitation sequences in adult trauma patients in-hospital to direct future research and guide evidence-based recommendations for management.

Methods: A literature search was conducted on PubMed, Embase, and Google Scholar until September 29, 2022.

How well do we understand our patients' perioperative experience? A qualitative analysis of themes derived from patient-centric resident conferences.

Background: Patient-centric resident conferences (PCRCs) provide meaningful time to connect with and learn from patients. This qualitative study explores themes of patients' perioperative experiences from PCRCs through patient and resident perspectives.

Methods: General Surgery residents participated in six PCRCs, which include condensed standard didactics to accommodate a patient panel regarding their perioperative experience.

Incidence of traumatic intracranial hemorrhage expansion after stable repeat head imaging: A retrospective cohort study.

Introduction: Patients with traumatic intracranial hemorrhage (tICH) often require intensive care unit (ICU) admission until bleeding stability is demonstrated through interval head computed tomography (HCT). The brain injury guidelines (BIG) suggest a minimum 24-h ICU admission for severe patients (BIG 3) regardless of repeat CT stability. We sought to evaluate the rate of tICH expansion after an initial stable interval scan was obtained.

Revitalizing the Patient-Surgeon Relationship: Surgical Curriculum Including the Patient Perspective.

Objective: General Surgery residents have increasing obligations that limit time with patients. This affects the patient-physician relationship, decreases meaning in work and increases burnout. Patient-Centric Resident Conferences (PCRC) incorporate patients in resident didactics to promote meaning in work and improve resident confidence in counseling and consenting patients for surgery.

Development of an Assessment Tool for Surgeons in Their First Year of Independent Practice: The Junior Surgeon Performance Assessment Tool.

Objective: The purpose of this study was to create an assessment tool to evaluate newly practicing surgeons.

Design: In this prospective mixed methods study, a needs assessment was performed by conducting focus groups with practicing general surgeons, asking questions regarding essential surgeon qualities, behaviors observed in inexperienced surgeons, current assessment methods, and desired assessment tool elements and attributes. A qualitative analysis was performed using a grounded theory methodology.

Selective aortic arch perfusion with fresh whole blood or HBOC-201 reverses hemorrhage-induced traumatic cardiac arrest in a lethal model of noncompressible torso hemorrhage.

Background: Hemorrhage-induced traumatic cardiac arrest (HiTCA) has a dismal survival rate. Previous studies demonstrated selective aortic arch perfusion (SAAP) with fresh whole blood (FWB) improved the rate of return of spontaneous circulation (ROSC) after HiTCA, compared with resuscitative endovascular balloon occlusion of the aorta and cardiopulmonary resuscitation (CPR). Hemoglobin-based oxygen carriers, such as hemoglobin-based oxygen carrier (HBOC)-201, may alleviate the logistical constraints of using FWB in a prehospital setting.

Factors influencing amount of guidance in the operating room during laparoscopic cases.

Background: Identifying factors associated with resident autonomy may help improve training efficiency. This study evaluates resident and procedural factors associated with level of guidance needed in the operating room.

Methods: Intraoperative performance and yearly performance on Fundamentals of Laparoscopic Surgery (FLS) tasks from 74 general surgery residents were retrospectively reviewed.

Implementation of a medical coding curriculum for surgery residents.

Background: Medical coding knowledge is important for practice. We hypothesized that general surgery residents lack confidence in medical coding (MC) and that implementation of focused didactics would increase resident confidence and knowledge.

Methods: A MC curriculum was delivered to general surgery residents covering domains of the global procedural period (GPP), evaluation and management (E/M) coding, and hospital payment and quality metrics (HPQM).

Resident autonomy in the operating room: Does gender matter?

Introduction: Previous data examining the effect of gender on surgical trainee autonomy is lacking. We hypothesized that female general surgery residents have less autonomy than males during laparoscopic cases.

Methods: We retrospectively reviewed factors associated with level of guidance needed during laparoscopic procedures as reported on intraoperative procedure feedback forms and on FLS tasks from one institution from 2013 to 2016.

Efficacy of the Abdominal Aortic Junctional Tourniquet-Torso Plate in a Lethal Model of Noncompressible Torso Hemorrhage.

Background: The Abdominal Aortic Junctional Tourniquet, when modified with an off-label, prototype, accessory pressure distribution plate (AAJT-TP), has the potential to control noncompressible torso hemorrhage in prolonged field care.

Methods: Using a lethal, noncompressible torso hemorrhage model, 24 male Yorkshire swine (81kg-96kg) were randomly assigned into two groups (control or AAJT-TP). Anesthetized animals were instrumented and an 80% laparoscopic, left-side liver lobe transection was performed.

Assessing the Value of Endoscopy Simulator Modules Designed to Prepare Residents for the Fundamentals of Endoscopic Surgery Examination.

Background: The Fundamentals of Endoscopic Surgery examination is required for all general surgery residents. The test modules are not available for practice before the examination; however, similar modules are commercially available.

Objective: This study aims to determine which modules are most valuable for resident training and preparation for the examination by evaluating which correlates best with experience level.

What They May Not Tell You and You May Not Know to Ask: What is Expected of Surgeons in Their First Year of Independent Practice.

Objective: The objective of this study was to explore the views and expectations that practicing general surgeons have of their junior colleagues who have recently finished training.

Design: This is a qualitative study performed using focus group data consisting of open-ended questions concentrating on essential qualities and attributes of surgeons, behaviors observed in newly-graduated surgeons, and appropriate oversight of junior partners. Qualitative analysis was performed using grounded theory methodology with transcripts coded by 3 independent reviewers.

Analysis of Gender-based Differences in Surgery Faculty Compensation, Promotion, and Retention: Establishing Equity.

Objectives: The objectives of this study were to evaluate gender-based differences in faculty salaries before and after implementation of a university-wide objective compensation plan, Faculty First (FF), in alignment with Association of American Medical Colleges regional median salary (AAMC-WRMS). Gender-based differences in promotion and retention were also assessed.

Summary Background Data: Previous studies demonstrate that female faculty within surgery are compensated less than male counterparts are and have decreased representation in higher academic ranks and leadership positions.

Computerized Residency Interview Scheduling: A Randomized Controlled Trial of Categorical General Surgery Applicants.

Objective: Scheduling interviews can be stressful and time-intensive for general surgery applicants and program coordinators. The objectives of this study were to determine whether computerized scheduling program (CSP) would decrease time to schedule interviews, reduce workload for residency coordinators, and improve applicant satisfaction.

Design: A prospective randomized controlled trial of 2 interview-scheduling methods was conducted.

PGY-specific benchmarks improve resident performance on Fundamentals of Laparoscopic Surgery tasks.

Background: Although expert proficiency times for Fundamentals of Laparoscopic Surgery (FLS) tasks exist, these times are not always attainable for junior residents. We hypothesize that post-graduate year (PGY)-specific benchmarks will improve resident performance of FLS tasks.

Methods: In 2014, PGY-specific benchmarks were developed for FLS tasks for PGY1-PGY4 general surgery residents by averaging completion times for each task from 2007 to 2013.

The minus-end actin capping protein, UNC-94/tropomodulin, regulates development of the Caenorhabditis elegans intestine.

Background: Tropomodulins are actin-capping proteins that regulate the stability of the slow-growing, minus-ends of actin filaments. The C. elegans tropomodulin homolog, UNC-94, has sequence and functional similarity to vertebrate tropomodulins.

The yeast homologue of the microtubule-associated protein Lis1 interacts with the sumoylation machinery and a SUMO-targeted ubiquitin ligase.

Microtubules and microtubule-associated proteins are fundamental for multiple cellular processes, including mitosis and intracellular motility, but the factors that control microtubule-associated proteins (MAPs) are poorly understood. Here we show that two MAPs-the CLIP-170 homologue Bik1p and the Lis1 homologue Pac1p-interact with several proteins in the sumoylation pathway. Bik1p and Pac1p interact with Smt3p, the yeast SUMO; Ubc9p, an E2; and Nfi1p, an E3.