Implementation of an Intensive Surgical Simulation Week for Medical Students in Rwanda.

Introduction: Simulation-based training often fails to meet the needs of low- and middle-income countries with limited access to high-cost models. We built on an existing surgical simulation curriculum for medical students in Rwanda and assessed students' experience.

Methods: Based on a contextual simulation-based education curriculum that was piloted in 2022, our team designed and delivered an intensive week-long surgical simulation course for medical students.

Surgical capacity is disaster preparedness: A scoping review of how surgery and anesthesiology departments responded to COVID-19.

Objective: This study evaluated how surgical and anesthesiology departments adapted their resources in response to the coronavirus disease 2019 (COVID-19) pandemic.

Design: This scoping review used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol, with Covidence as a screening tool. An initial search of PubMed, Embase, Web of Science, Global Index Medicus, and Cochrane Systematic Reviews returned 6,131 results in October 2021.

The Implementation of Simulation-Based Learning for Training Undergraduate Medical Students in Essential Surgical Care Across Sub-Saharan Africa: a Scoping Review.

Much surgery in sub-Saharan Africa is provided by non-specialists who lack postgraduate surgical training. These can benefit from simulation-based learning (SBL) for essential surgery. Whilst SBL in high-income contexts, and for training surgical specialists, has been explored, SBL for surgical training during undergraduate medical education needs to be better defined.

A national perspective on exposure to essential surgical procedures among medical trainees in Nigeria: a cross-sectional survey and recommendations.

Background: In sub-Saharan Africa, recent graduates from medical school provide more direct surgical and procedural care to patients than their counterparts from the Global North. Nigeria has no nationally representative data on the procedures performed by trainees before graduation from medical school and their confidence in performing these procedures upon graduation has also not been evaluated.

Methods: We performed an internet-based, cross-sectional survey of recent medical school graduates from 15 accredited Federal, State, and private Nigerian medical schools spanning six geopolitical zones.

Determining Critical Topics for Undergraduate Surgical Education in Rwanda: Results of a Modified Delphi Process and a Consensus Conference.

Background Developing a contextually appropriate curriculum is critical to train physicians who can address surgical challenges in sub-Saharan Africa. An innovative modified Delphi process was used to identify contextually optimized curricular content to meet sub-Saharan Africa and Rwanda's surgical needs. Methods Participants were surgeons from East, Central, Southern, and West Africa and general practitioners with surgical experience.

Global Access to Cardiac Surgery Centers: Distribution, Disparities, and Targets.

Background: Global data on cardiac surgery centers are outdated and survey-based. In 1995, there were 0.7 centers per million population, ranging from one per 120,000 in North America to one per 33 million in sub-Saharan Africa.

Developing a Surgical Simulation Curriculum for the Rwandan Context.

Objective: We report on the development and implementation of a surgical simulation curriculum for undergraduate medical students in rural Rwanda.

Design: This is a narrative report on the development of scenario and procedure-based content for a junior surgical clerkship simulation curriculum by an interdisciplinary team of simulation specialists, surgeons, anesthesiologists, medical educators, and medical students.

Setting: University of Global Health Equity, a new medical school located in Butaro, Rwanda.

The safe introduction of robotic surgery in a free-standing children's hospital.

The aim of this study is to report the experience of implementing a pediatric robotic surgery program at a free-standing pediatric teaching hospital. A database was created to prospectively collect perioperative data for all robotic surgeries performed by the pediatric surgery department. The database was queried for all operations completed from October 2015 to December 2021.

Pediatric Single-Incision Robotic Cholecystectomy: A 6-Year Update from a Single Institution.

In children, gallbladder disease has become more common due to the rise in childhood obesity and subsequent shift in etiology. While the gold standard of surgical management remains a laparoscopic technique, there has been increasing interest in robotic-assisted techniques. The aim of this study is to report a 6-year update on the experience of treating gallbladder disease with robotic-assisted surgery at a single institution.

Exploring the distribution of risk factors for drop-out from Ponseti treatment for clubfoot across Bangladesh using geospatial cluster analysis.

Clubfoot is a congenital anomaly affecting 1/1,000 live births. Ponseti casting is an effective and affordable treatment. About 75% of affected children have access to Ponseti treatment in Bangladesh, but 20% are at risk of drop-out.

Simulation-Based Breast Biopsy Training Using a Low-Cost Gelatin-Based Breast Model in Rwanda.

Background: An interdisciplinary team of healthcare providers and simulation specialists adopted and modified a protocol for the creation of a low-cost, gelatin-based breast model for teaching ultrasound-guided breast biopsy and assessed first-time user experience.

Methods: An interdisciplinary team of healthcare providers and simulation specialists adopted and modified a protocol for the creation of a low-cost, gelatin-based breast model for teaching ultrasound-guided breast biopsy for approximately $4.40 USD.

Social vulnerability index and firearms: How neighborhood health disparities affect trauma outcomes.

Background: Firearm injuries' association with individual-level socioeconomic risk is well described. Trauma research has suggested that neighborhood level risk factors may be associated with differences in firearm injury outcome. We analyzed the relationship between hospital length of stay (LOS), mortality and neighborhood level social markers from the Center for Disease Control (CDC) Social Vulnerability Index (SVI) after firearm injury.

Percutaneous endoscopic gastrostomy tube placement via the introducer technique is safe and effective in children when compared to the laparoscopic technique.

Purpose: We compare our experience of percutaneous endoscopic gastrostomy, introducer technique (PEG) and laparoscopic technique (LapGT) at a tertiary care pediatric hospital.

Methods: Isolated PEGs and LapGTs placements were reviewed at our institution from August 2016 through January 2018. Demographics, procedure time, operative charges, and 30-day complications were reviewed.

The Epidemiology and Outcome of Pericardial Effusion in Hospitalized Children: A National Database Analysis.

Objectives: To describe the epidemiology of pericardial effusion in hospitalized children and evaluate risk factors associated with the drainage of pericardial effusion and hospital mortality.

Study Design: A retrospective study of a national pediatric discharge database.

Results: We analyzed hospitalized pediatric patients from the neonatal age through 20 years in the Kids' Inpatient Database 2016, extracting the cases of pericardial effusion.

Early discharge on postoperative day 1 following lobectomy for stage I non-small-cell lung cancer is safe in high-volume surgical centres: a national cancer database analysis.

Objectives: Shortening hospital length of stay after lobectomy for stage I non-small-cell lung cancer (NSCLC) remains a challenge, and the literature regarding factors associated with safe early discharge is limited. We sought to evaluate the safety of postoperative day (POD) 1 discharge after lobectomy and its correlation with institutional caseload using the National Cancer Database, jointly sponsored by the American College of Surgeons and the American Cancer Society.

Methods: We identified patients with stage I NSCLC (tumour ≤4 cm, clinical N0, M0) in the National Cancer Database who underwent lobectomy from 2010 to 2015.

Resource Mobilization for Global Surgery: Lessons Learned From US Government Appropriations Advocacy.

The US Agency for International Development (USAID) receives directives and funding through the appropriation process, though until recently, global surgery was not included in its mission. Nevertheless, an estimated five billion people lack access to safe, timely, and affordable surgical care, in large part due to lack of economic resources. Using coalition-based advocacy, the G4 Alliance successfully developed and submitted language that was incorporated into the 2020 Appropriations report language, directing USAID to financially support global surgery.

Initial Experience with Robotic Inguinal Hernia Repair in the Adolescent Population.

There is no one standard procedure encompassing the needs and differences of the entire pediatric population for inguinal hernia repair (IHR). Several techniques can be used, including open repair, laparoscopic, and robotic-assisted laparoscopic repair. This is a report of a single pediatric hospital's experience performing robotic-assisted IHRs in an adolescent population.

Investments in surgical systems contribute to pandemic readiness and health system resilience.

Safe surgical care, including anesthesia, obstetrics, and trauma, is an essential component of a functional health system, yet five billion people lack access to high-quality, timely and affordable surgical care. As health decision makers are grappling with how to make appropriate investments for crisis readiness and resilience, investments in surgical care should be considered for their compounding benefits to meet a country's diverse health goals. National Surgical, Obstetric, and Anesthesia Plans (NSOAPs) are developed through global partnerships and multi-stakeholder consensus and provide a dynamic framework for surgical scale-up that also improves the resilience of the larger health system.

Ultra-High Field Diffusion MRI Reveals Early Axonal Pathology in Spinal Cord of ALS mice.

Background: Amyotrophic lateral sclerosis (ALS) is a disease characterized by a progressive degeneration of motor neurons leading to paralysis. Our previous MRI diffusion tensor imaging studies detected early white matter changes in the spinal cords of mice carrying the G93A-SOD1 mutation. Here, we extend those studies using ultra-high field MRI (17.