Implementation of Routine In Situ Simulation in Residency Curriculum Targeting Competency in Technical and Decision-Making Skills.

Objective: To describe the development and implementation of a comprehensive in situ simulation-based curriculum for anesthesia residents.

Design: This is a prospective study.

Setting: This study was conducted at a university hospital.

Neoantigen-specific stimulation of tumor-infiltrating lymphocytes enables effective TCR isolation and expansion while preserving stem-like memory phenotypes.

Background: Tumor-infiltrating lymphocytes (TILs) targeting neoantigens can effectively treat a selected set of metastatic solid cancers. However, harnessing TILs for cancer treatments remains challenging because neoantigen-reactive T cells are often rare and exhausted, and ex vivo expansion can further reduce their frequencies. This complicates the identification of neoantigen-reactive T-cell receptors (TCRs) and the development of TIL products with high reactivity for patient treatment.

Underrepresented in Medicine Applicants are Less Likely to Successfully Match into Plastic Surgery.

Importance: The lack of underrepresented in medicine physicians in academic plastic surgery has been a topic of interest for many years, and accordingly outreach has been undertaken to address the pipeline from medical school to residency and beyond.

Objective: This study aims to assess and identify the characteristics associated with plastic surgery match success for underrepresented in medicine applicants.

Design: Residency application data for first time, US allopathic medical school seniors from the 2017-2018 to 2021-2022 applicant cycles were abstracted from Electronic Residency Application Service applications, and match results were determined using the National Residency Matching Program database and online public sources.

Pediatric Plastic Surgery in the COVID-19 Era.

The COVID-19 pandemic has forced the healthcare system to adopt novel strategies to treat patients. Pediatric plastic surgeons are uniquely exposed to high rates of infections during examinations and surgeries via aerosol-generating procedures, in part because of the predilection of viral particles for the nasal cavities and pharynx. Telemedicine has emerged as a useful virtual medium for encouraging prolonged patient follow-up while maintaining physical distance.

Phenotypic signatures of circulating neoantigen-reactive CD8 T cells in patients with metastatic cancers.

Circulating T cells from peripheral blood (PBL) can provide a rich and noninvasive source for antitumor T cells. By single-cell transcriptomic profiling of 36 neoantigen-specific T cell clones from 6 metastatic cancer patients, we report the transcriptional and cell surface signatures of antitumor PBL-derived CD8 T cells (NeoTCR). Comparison of tumor-infiltrating lymphocyte (TIL)- and PBL-neoantigen-specific T cells revealed that NeoTCR T cells are low in frequency and display less-dysfunctional memory phenotypes relative to their TIL counterparts.

Vaginal Reconstruction in the Pediatric Population: An Analysis of a National Database.

Objective: In the pediatric population, vaginoplasties can be performed in patients with either congenital malformations or acquired conditions. To our knowledge, there has been no study to date investigating the outcomes of vaginoplasty in the pediatric population using a nationwide database. Here, we present a national cohort study of perioperative characteristics and 30-day complications of vaginoplasty in pediatric patients.

Induction of bronchus-associated lymphoid tissue is an early life adaptation for promoting human B cell immunity.

Infants and young children are more susceptible to common respiratory pathogens than adults but can fare better against novel pathogens like severe acute respiratory syndrome coronavirus 2. The mechanisms by which infants and young children mount effective immune responses to respiratory pathogens are unknown. Through investigation of lungs and lung-associated lymph nodes from infant and pediatric organ donors aged 0-13 years, we show that bronchus-associated lymphoid tissue (BALT), containing B cell follicles, CD4 T cells and functionally active germinal centers, develop during infancy.

Mission Disimpaction: Endoscopic Management of Stercoral Colitis in an Adolescent.

Stercoral colitis is a rare entity of inflammatory colitis with high morbidity and mortality attributable to colonic fecaloma impaction, often a result of chronic constipation. Despite demographic imbalance favoring elders, children hold comparative risk factors for chronic constipation. Suspicion for stercoral colitis is warranted in nearly every stage of life.

Evaluation of the Virtual Interviews for Resident Recruitment Due to COVID-19 Travel Restrictions: A Nationwide Survey of US Senior Medical Students.

Background And Objectives: Due to COVID-19, residency programs could not conduct in-person interviews during the 2020-2021 match and were forced to implement a virtual format. We conducted a nationwide survey of US senior medical students to evaluate their perception of the virtual interview process and to solicit their recommendations for future virtual interview best practices.

Methods: This study was administered to US fourth-year medical students currently participating in the residency match using Survey Monkey during March 2021.

Defining and Addressing Anesthesiology Needs in Simulation-based Medical Education.

Background: This study's primary aim was to determine how training programs use simulation-based medical education (SBME), because SBME is linked to superior clinical performance.

Methods: An anonymous 10-question survey was distributed to anesthesiology residency program directors across the United States. The survey aimed to assess where and how SBME takes place, which resources are available, frequency of and barriers to its use, and perceived utility of a dedicated departmental education laboratory.

Adult and Elderly Risk Factors of Mortality in 23,614 Emergently Admitted Patients with Rectal or Rectosigmoid Junction Malignancy.

Background: Colorectal cancer, among which are malignant neoplasms of the rectum and rectosigmoid junction, is the fourth most common cancer cause of death globally. The goal of this study was to evaluate independent predictors of in-hospital mortality in adult and elderly patients undergoing emergency admission for malignant neoplasm of the rectum and rectosigmoid junction. Methods: Demographic and clinical data were obtained from the National Inpatient Sample (NIS), 2005−2014, to evaluate adult (age 18−64 years) and elderly (65+ years) patients with malignant neoplasm of the rectum and rectosigmoid junction who underwent emergency surgery.

Mortality Risk Factors in Patients Admitted with the Primary Diagnosis of Tracheostomy Complications: An Analysis of 8026 Patients.

Background: Tracheostomy is a procedure commonly conducted in patients undergoing emergency admission and requires prolonged mechanical ventilation. In the present study, the aim was to determine the prevalence and risk factors of mortality among emergently admitted patients with tracheostomy complications, during the years 2005−2014. Methods: This was a retrospective cohort study.

Divergent outer retinal circuits drive image and non-image visual behaviors.

Image- and non-image-forming vision are essential for animal behavior. Here we use genetically modified mouse lines to examine retinal circuits driving image- and non-image-functions. We describe the outer retinal circuits underlying the pupillary light response (PLR) and circadian photoentrainment, two non-image-forming behaviors.

Evaluation of the Virtual Interview Format for Resident Recruitment as a Result of COVID-19 Restrictions: Residency Program Directors' Perspectives.

Purpose: Due to the COVID-19 pandemic, residency programs could not conduct in-person interviews during the 2020-2021 Match cycle and were forced to implement a virtual format. The authors conducted a nationwide survey of residency program directors (PDs) to assess their confidence in using a virtual platform to holistically evaluate applicants during the 2020-2021 Match cycle and their desire to continue virtual recruitment during forthcoming interview seasons.

Method: This prospective study was conducted by email questionnaire administered through the survey tool Survey Monkey to residency PDs from March 7, 2021-March 27, 2021.

Independent Predictors of In-Hospital Mortality in Elderly and Non-elderly Adult Patients Undergoing Emergency Admission for Hemorrhoids.

Background: The study explored determinants of mortality of admitted emergently patients with the primary diagnosis of hemorrhoids, during the years 2005-2014.

Methods: Demographics, clinical data, and outcomes were obtained from the National Inpatient Sample, 2005-2014, in elderly (65+ years) and non-elderly adult patients (18-64 years) with hemorrhoids who underwent emergency admission. Multivariable logistic regression model with backward elimination was used to identify predictors of mortality.

Delayed Operation as a Major Risk Factor for Mortality Among Elderly Patients with Ventral Hernia Admitted Emergently: An Analysis of 33,700 Elderly Patients.

Background: Elderly patients admitted emergently for ventral hernia may have high rates of complications, including morbidity and mortality. The goal of this study was to retrospectively assess risk factors for in-hospital mortality for elderly patients admitted emergently with a primary diagnosis of ventral hernia.

Methods: Elderly patients with ventral hernia that required emergency admission were analyzed using the National Inpatient Sample database, 2005-2014.

Risk Factors for Mortality in Patients with Ventral Hernia Admitted Emergently: An Analysis of 48,539 Adult Patients.

Background: More than 400,000 cases of ventral hernia (VH) are repaired each year in the U.S. This condition is a major problem with significant morbidly and mortality.

Heme-oxygenase and lipid mediators in obesity and associated cardiometabolic diseases: Therapeutic implications.

Obesity-mediated metabolic syndrome remains the leading cause of death worldwide. Among many potential targets for pharmacological intervention, a promising strategy involves the heme oxygenase (HO) system, specifically its inducible form, HO-1. This review collects and updates much of the current knowledge relevant to pharmacology and clinical medicine concerning HO-1 in metabolic diseases and its effect on lipid metabolism.

Recent advances in benign gynecological laparoscopic surgery.

Minimally invasive surgery continues to transform the field of gynecological surgery and is now the standard of care for the surgical treatment of many diseases in gynecology. Owing to minimally invasive surgery's clear advantages, new advances in technology are being employed rapidly and enabling even the most complicated procedures to be performed less invasively. We examine recent literature on minimally invasive surgical innovations, advances, and common practices in benign gynecology that, from our point of view, made an impact on the way laparoscopic surgery is performed and managed in the last decade.

The effect of gallic acid interactions with iron-coated clay on surface redox reactivity.

Adsorption and redox reactions between organic matter and natural reactive surfaces have a significant impact on pollutant sequestration and transformation, and on the effectivity of water and soil remediation practices. Herein, the interactions between an organic phenolic acid, gallic acid (GA), and clay coated with iron oxides (FeOx-MMT), were explored. Adsorption and desorption experiments revealed that GA has a higher affinity for FeOx-MMT than for native clay.