A framework to improve retention of Black surgical trainees: A Society of Black Academic Surgeons white paper.

Attrition is high among surgical trainees, and six of ten trainees consider leaving their programs, with two ultimately leaving before completion of training. Given known historically and systemically rooted biases, Black surgical trainees are at high risk of attrition during residency training. With only 4.

Perianal Paget's-an aggressive disease.

Aim: Perianal Paget's disease (PAPD) is a rare disorder with a predisposition to anal and colorectal malignancies and an unclear prognosis. Our previous 25-year series demonstrated a non-aggressive nature. This study aims to describe our updated institutional experience.

Management of Diverticulitis in Renal Transplant Patients.

Background: Renal transplant patients presenting with diverticulitis remain a clinical challenge for health care professionals. Secondary to immunosuppression, renal transplant recipients are often considered for early operative intervention due to concerns for an unreliable physical exam and feared morbidity and mortality associated with non-operative management.

Methods: This study aimed to evaluate trends in management of renal transplant patients with diverticulitis at a quaternary referral center.

Open innovation facilitates department-wide engagement in quality improvement: experience from the Massachusetts General Hospital.

Background: Quality improvement (QI) initiatives commonly originate 'top-down' from senior leadership, as staff engagement is often sporadic. We describe our experience with a technology-enabled open innovation contest to encourage participation from multiple stakeholders in a Department of Surgery (DoS) to solicit ideas for QI. We aimed to stimulate engagement and to assist DoS leadership in prioritizing QI initiatives.

The impact of race on choice of location for elective surgical care in New York city.

Background: The "white-flight" phenomenon of the mid-20th century contributed to the perpetuation of residential segregation in American society. In light of recent reports of racial segregation in our healthcare system, could a contemporary "white-flight" phenomenon also exist?

Methods: The New York Statewide Planning and Research Cooperative System was used to identify all Manhattan and Bronx residents of New York city who underwent elective cardiothoracic, colorectal, general, and vascular surgeries from 2010 to 2016. Primary outcome was borough of surgical care in relation to patient's home borough.

Beyond insurance: race-based disparities in the use of metabolic and bariatric surgery for the management of severe pediatric obesity.

Background: It is unknown whether previously noted racial disparities in the use of metabolic and bariatric surgery (MBS) for the management of pediatric obesity could be mitigated by accounting for primary insurance.

Objectives: To examine utilization of pediatric MBS across race and insurance in the United States.

Setting: Retrospective cross-sectional study.

Does the Day of the Week Predict a Cesarean Section? A Statewide Analysis.

Background: Although guidelines for clinical indications of cesarean sections (CS) exist, nonclinical factors may affect CS practices. We hypothesize that CS rates vary by day of the week.

Methods: An analysis of the Office of Statewide Health Planning and Development database for California from 2006 to 2010 was performed.

Is the Power Threshold of 0.8 Applicable to Surgical Science?-Empowering the Underpowered Study.

Background: Many articles in the surgical literature were faulted for committing type 2 error, or concluding no difference when the study was "underpowered". However, it is unknown if the current power standard of 0.8 is reasonable in surgical science.

Nature versus nurture: the impact of nativity and site of treatment on survival for gastric cancer.

Background: The prognosis of gastric cancer patients is better in Asia than in the West. Genetic, environmental, and treatment factors have all been implicated. We sought to explore the extent to which the place of birth and the place of treatment influences survival outcomes in Korean and US patients with localized gastric cancer.

Reducing road traffic deaths: where should we focus global health initiatives?

Background: Current global surgery initiatives focus on increasing surgical workforce; however, it is unclear whether this approach would be helpful globally, as patients in low-resource countries may not be able to reach hospitals in a timely fashion without formal Emergency Medical Services (EMS). We hypothesize that increased surgical workforce correlates with decreased road traffic deaths (RTDs) only in countries with EMS.

Methods: Estimated RTDs were obtained from the Global Status Report on Road Safety 2013, which estimated the RTD rate in 2010 (RTD 2010).

Favorable impact of thoracic endovascular aortic repair on survival of patients with acute uncomplicated type B aortic dissection.

Background: In uncomplicated type B aortic dissection (UTBAD), the "gold standard" has been nonoperative treatment with medical therapy, although this has been questioned by studies demonstrating improved outcomes in those treated with thoracic endovascular aortic repair (TEVAR). This study assessed long-term survival after acute UTBAD comparing medical therapy, open repair, and TEVAR.

Methods: The California Office of Statewide Hospital Planning Development database was analyzed from 2000 to 2010 for adult patients with acute UTBAD.

Race/Ethnicity and Age Distribution of Breast Cancer Diagnosis in the United States.

This study assesses the age distribution of breast cancer diagnosis across race/ethnicity in US female patients using the Surveillance, Epidemiology, and End Results Program database.

How Much Data are Good Enough? Using Simulation to Determine the Reliability of Estimating POMR for Resource-Constrained Settings.

Introduction: Perioperative mortality rate (POMR) is a suggested indicator for surgical quality worldwide. Currently, POMR is often sampled by convenience; a data-driven approach for calculating sample size has not previously been attempted. We proposed a novel application of a bootstrapping sampling technique to estimate how much data are needed to be collected to reasonably estimate POMR in low-resource countries where 100% data capture is not possible.

Variation in Amputation Risk for Black Patients: Uncovering Potential Sources of Bias and Opportunities for Intervention.

Background: Differences in amputation rates for limb ischemia between white and black patients have been extensively studied. Our goal was to determine whether biases in provider decision-making contribute to the disparity. We hypothesized that the magnitude of the disparity is affected by surgeon and hospital factors.

Fifteen years of adrenalectomies: impact of specialty training and operative volume.

Background: Previous associations between surgeon volume with adrenalectomy outcomes examined only a sample of procedures. We performed an analysis of all adrenalectomies performed in New York state to assess the effect of surgeon volume and specialty on clinical outcomes.

Methods: Adrenalectomies performed in adults were identified from the New York Statewide Planning and Research Cooperative System from 2000-2014.

Is Annual Volume Enough? The Role of Experience and Specialization on Inpatient Mortality After Hepatectomy.

Objective: To investigate the effect of subspecialty practice and experience on the relationship between annual volume and inpatient mortality after hepatic resection.

Background: The impact of annual surgical volume on postoperative outcomes has been extensively examined. However, the impact of cumulative surgeon experience and specialty training on this relationship warrants investigation.