CLAMity: Mixtures of agricultural pesticides as multiple stressors in a bivalve species.

Pesticides play a vital role in ensuring global food security amid a growing global population; however, their movement away from application sites can pose significant risks to the health of non-target species. Pollution of freshwater is a key contributor to the high extinction rates of freshwater species, which often face exposure to a complex "cocktail" of pollutants simultaneously. A better understanding of pesticide interactions will enable more targeted policies and land management practices to mitigate environmental damage while ensuring food security.

National trends, safety, and effectiveness of minimally invasive concomitant chest wall resection for locally advanced lung cancer.

Objective: Concomitant chest wall resection for locally advanced lung cancer is traditionally performed via an open approach. The safety and effectiveness of minimally invasive approaches for chest wall resections are unknown.

Methods: We used the National Cancer Database to identify patients undergoing lobectomy/bi-lobectomy with concomitant chest wall resection from 2010 to 2020.

Comparing the Fate and Transport of MS2 Bacteriophage and Sodium Fluorescein in a Karstic Chalk Aquifer.

Groundwater flow and contaminant migration tracing is a vital method of identifying and characterising pollutant source-pathway-receptor linkages in karst aquifers. Bacteriophages are an attractive alternative tracer to non-reactive fluorescent dye tracers, as high titres (>10 pfu mL) can be safely released into the aquifer, offering improved tracer detectability. However, the interpretation of bacteriophage tracer breakthrough curves is complicated as their fate and transport are impacted by aquifer physicochemical conditions.

Music Perception in Bone-Anchored Hearing Implant Users.

Objective: Music is a highly complex acoustic stimulus in both spectral and temporal contents. Accurate representation and delivery of high-fidelity information are essential for music perception. However, it is unclear how well bone-anchored hearing implants (BAHIs) transmit music.

Assessment of the pollution incident performance of water and sewerage companies in England.

Comparison of the severity, frequency and self-reporting of pollution incidents by water and sewerage companies is made difficult by differences in environmental and operational conditions. In England, the deterioration in pollution incident performance makes it important to investigate common trends that could be addressed to improve pollution management. This study presents the first external analysis of available national pollution incident data, obtained through Environmental Information Regulations 2004 requests to the English Environment Agency.

Template for a program tailored ACS/APDS phase 1 curriculum: From needs assessment to implementation.

Background: The Phase 1 ACS/APDS skills curriculum standardizes intern training. Despite this, institutional implementation varies and is nationally low. We aimed to use Kern's six-steps to tailor this to our program, providing a framework to improve implementation.

Safety of Surgical Telehealth in the Outpatient and Inpatient Setting.

New telehealth platforms and interventions have proliferated over the past decade and will be further spurred by the COVID-19 pandemic. Emerging literature examines the efficacy and safety of these interventions. Early pilot studies and trials demonstrate equivalent outcomes of telehealth interventions that seek to replace routine postoperative care in low-risk patients who have undergone low-risk surgeries.

Quality improvement education in surgical specialty training: A comparison of Vascular Surgery resident and Urology Resident experiences and attitudes.

Background: Academic institutions have increasingly focused on educating physicians and surgeons in concepts of value-based care, including quality improvement (QI). The extent to which QI curricular competencies are addressed in specialty surgical residency training is unclear.

Methods: A survey instrument was developed by content experts and sent to Vascular Surgery and Urology residents electronically.

Metaldehyde prediction by integrating existing water industry datasets with the soil and water assessment tool.

Metaldehyde (a synthetic aldehyde pesticide used globally in agriculture) has been internationally identified as an emerging contaminant of concern. This study aimed to integrate existing water industry, publicly available and purchased licensed datasets with the open-access Soil and Water Assessment Tool (SWAT), to establish if these datasets could be used to effectively model metaldehyde in river catchments. To achieve the study aim, a SWAT model was developed and calibrated for the River Medway catchment (UK).

Pathogen infection risk to recreational water users, associated with surface waters impacted by de facto and indirect potable reuse activities.

Water deficit, exacerbated by global population increases and climate change, necessitates the investigation of alternative non-traditional water sources to augment existing supplies. Indirect potable reuse (IPR) represents a promising alternative water source in water-stressed regions. Of high concern is the presence of pathogenic microorganisms in wastewater, such as enteric viruses, protozoa and bacteria.

Simulation training for the endoscopic management of upper gastrointestinal bleeding: a nationwide survey of rural surgeons' needs and preferences analysis.

Background: Published needs analyses of rural surgeons have identified a need for training in the endoscopic management of non-variceal upper gastrointestinal bleeding (NVUGIB). The study aim was to survey rural surgeons regarding their requirements and preferences for a simulation model on which they could rehearse the endoscopic management of NVUGIB.

Methods: Rural surgeons were contacted via the American College of Surgery Advisory Council listserv and invited to complete an online survey.

Potential microbial transmission pathways in rural communities using multiple alternative water sources in semi-arid Brazil.

Background: Water scarcity combined with high incidences of diarrhoeal disease amongst many rural communities, suggests that the provision of 'safe' water supplies remains a challenge. Subsequent reliance on multi-source water supplies means that microbial transmission pathways may be numerous and complex.

Objectives: This study aimed to identify and elucidate water supply issues and potential microbial transmission pathways at the household level in rural communities in semi-arid Brazil.

A National Survey of Integrated Vascular Surgery Residents' Experiences With and Attitudes About Quality Improvement During Residency.

Background: Integrated vascular surgery residency, or "0+5," programs provide education in the Accreditation Council for Graduate Medical Education (ACGME) competencies of Systems-Based Practice (SBP) and Practice-Based Learning and Improvement (PBLI), which include milestones related to quality improvement (QI). It is unclear what QI curricula are in place in 0+5 programs nationally or how 0+5 residents perceive the importance of QI.

Objective: The purpose of this study is to assess current 0+5 residents' knowledge, experiences with, and attitudes about QI.

An Age-Based Analysis of Pediatric Melanoma: Staging, Surgery, and Mortality in the Surveillance, Epidemiology, and End Results Database.

The pediatric melanoma population is not well described, and current guidelines for their management are not well defined. Our study aims to identify this population, treatment modalities, and outcomes using a national population-based database. We reviewed the Surveillance, Epidemiology, and End Results database (2004-2008).

Financial Relationships between Urologists and Industry: An Analysis of Open Payments Data.

Introduction: The Open Payments Program was enacted to increase transparency of financial relationships between physicians and the medical device and pharmaceutical industry. We examined nonresearch related financial relationships between urologists and industry in the United States using the latest Open Payments data.

Methods: We performed a descriptive analysis of Open Payments data released by the Centers for Medicare and Medicaid Services for 2014.

Human-specific phages infecting Enterococcus host strain MW47: are they reliable microbial source tracking markers?

Aim: The aim of this study was to determine the morphological diversity and environmental survival of human-specific phages infecting Enterococcus faecium host strain MW47, to support their use as microbial source tracking (MST) markers.

Methods And Results: Twenty phages capable of infecting strain MW47 were propagated and their morphologies were determined using transmission electron microscopy (TEM), which revealed that a heterogeneous group of phages was able to infect strain MW47. Three distinct morphologies from two different families (Myoviridae and Siphoviridae) were observed.

Targeted biopsy: benefits and limitations.

Purpose Of Review: To review the current literature regarding the role of multiparametric MRI and fusion-guided biopsies in urologic practice.

Recent Findings: Fusion biopsies consistently show an increase in the detection of clinically significant cancers and decrease in low-risk disease that may be more suitable for active surveillance. Although, when to incorporate multiparametric MRI into workup is not clearly agreed upon, studies have shown a clear benefit in both biopsy naïve and those with prior negative biopsies in determining the appropriate treatment strategy.

Lymph node dissection during radical cystectomy following prior radiation therapy: results from the SEER database.

Purpose: Population studies of patients undergoing radical cystectomy (RC) for bladder cancer (BC) suggest that a more extended lymph node dissection (LND) increases survival. However, information regarding LNDs of patients undergoing RC with a history of radiation therapy for BC is largely unknown. This study aims to define the lymph node yield (LNY) in patients undergoing RC for BC following radiation of the bladder using the surveillance epidemiology and end results (SEER) database.

Genitourinary paraganglioma: Demographic, pathologic, and clinical characteristics in the surveillance, epidemiology, and end results database (2000-2012).

Background: Extra-adrenal paragangliomas (PGLs) are infrequent, benign, and neuroendocrine tumors arising from chromaffin cells of the autonomic nervous system. Most PGLs are sporadic, but up to 32% are associated with inherited syndromes such as neurofibromatosis type 1, von Hippel-Lindau disease, and familial PGL. Although most PGLs develop above the umbilicus, they have been reported in the genitourinary (GU) tract.

Pegylated-asparaginase during induction therapy for adult acute lymphoblastic leukaemia: toxicity data from the UKALL14 trial.

Safety and efficacy data on pegylated asparaginase (PEG-ASP) in adult acute lymphoblastic leukaemia (ALL) induction regimens are limited. The UK National Cancer Research Institute UKALL14 trial NCT01085617 prospectively evaluated the tolerability of 1000 IU/m PEG-ASP administered on days 4 and 18 as part of a five-drug induction regimen in adults aged 25-65 years with de novo ALL. Median age was 46.

The application of phage-based faecal pollution markers to predict the concentration of adenoviruses in mussels (Mytilus edulis) and their overlying waters.

Aim: This study set out to determine whether phage-based indicators may provide a 'low-tech' alternative to existing approaches that might help maintain the microbial safety of shellfish and their overlying waters.

Methods And Results: Mussels and their overlying waters were collected biweekly from an estuary in southeast England over a 2-year period (May 2013-April 2015) (n = 48). Levels of bacterial indicators were determined using membrane filtration and most probable number methods and those of bacteriophages were determined by direct plaque assay.

Removal of phages and viral pathogens in a full-scale MBR: Implications for wastewater reuse and potable water.

The aim of this study was to demonstrate how seasonal variability in the removal efficacy of enteric viral pathogens from an MBR-based water recycling system might affect risks to human health if the treated product were to be used for the augmentation of potable water supplies. Samples were taken over a twelve month period (March 2014-February 2015), from nine locations throughout a water recycling plant situated in East London and tested for faecal indicator bacteria (thermotolerant coliforms, intestinal enterococci n = 108), phages (somatic coliphage, F-specific RNA phage and Bacteroides phage (GB-124) n = 108), pathogenic viruses (adenovirus, hepatitis A, norovirus GI/GII n = 48) and a range of physico-chemical parameters (suspended solids, DO, BOD, COD). Thermotolerant coliforms and intestinal enterococci were removed effectively by the water recycling plant throughout the study period.

Revision of Roux-En-Y Gastric Bypass for Weight Regain: a Systematic Review of Techniques and Outcomes.

Background: Weight regain has led to an increase in revision of Roux-en-Y gastric bypass (RYGB) surgeries. There is no standardized approach to revisional surgery after failed RYGB. We performed an exhaustive literature search to elucidate surgical revision options.