Incomplete Resection Is Twice as Likely in Locally Advanced Mucinous Compared to Nonmucinous Rectal Adenocarcinoma: A National Propensity-Matched Analysis.

Background And Objectives: Rectal mucinous adenocarcinoma (MA) has poor response to neoadjuvant chemoradiation (NCR) and higher involved radial surgical margin rates than nonmucinous rectal adenocarcinoma (NMA).

Methods: The National Cancer Database (2010-2018) was queried for adult patients with clinical stage II and III rectal cancer. Patients with MA and NMA treated with NCR and total mesorectal excision (TME) were identified.

DMEK Surgery at a Tertiary Hospital in Sweden. Results and Complication Risks.

Purpose: This study reports clinical outcomes up to 6 years after Descemet's membrane endothelial keratoplasty (DMEK) performed at the Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.

Methods: The study has a cross-sectional and case series design. Inclusion criteria were all DMEK-operated eyes during 2013-2018 until repeat keratoplasty.

The role of rectal magnetic resonance imaging in accurate localization and designation of colorectal cancer for optimal management: Case study.

Colorectal cancer, developing from malignant transformation of the distal gut epithelium, is the second leading cause of cancer death in the United States. We present a gentleman in his 60s who was diagnosed with colorectal cancer during a routine screening colonoscopy with no evidence of distant metastasis on subsequent staging with positron emission tomography and computed tomography (PET-CT). The outside rectal MR (magnetic resonance) imaging report localized a mass to the upper rectum.

Physics mechanisms underlying the optimization of coherent heat transfer across width-modulated nanowaveguides with calculations and machine learning.

Optimization of heat transfer at the nanoscale is necessary for efficient modern technology applications in nanoelectronics, energy conversion, and quantum technologies. In such applications, phonons dominate thermal transport and optimal performance requires minimum phonon conduction. Coherent phonon conduction is minimized by maximum disorder in the aperiodic modulation profile of width-modulated nanowaveguides, according to a physics rule.

Towards Optimizing Width Modulation for Maximum Thermoelectric Efficiency.

Maximizing thermoelectric efficiency is typically addressed as identical to minimizing parasitic thermal conduction. Such an approach relies on the assumption that the adopted strategy mainly affects phonons, leaving electrons intact, and is not justified in many cases of non-uniform nanostructures such as width-modulated nanowaveguides, where both electrons and phonons are significantly affected by width modulation. Here, we address the question of maximizing the thermoelectric efficiency of this class of metamaterials by exploring the effect of the modulation extent on both electron and phonon transport.

Clinical Tools for Rectal Cancer Response Assessment following Neoadjuvant Treatment in the Era of Organ Preservation.

Local tumor response evaluation following neoadjuvant treatment(s) in rectal adenocarcinoma requires a multi-modality approach including physical and endoscopic evaluations, rectal protocoled MRI, and cross-sectional imaging. Clinical tumor response exists on a spectrum from complete clinical response (cCR), defined as the absence of clinical evidence of residual tumor, to near-complete response (nCR), which assumes a significant reduction in tumor burden but with increased uncertainty of residual microscopic disease, to incomplete clinical response (iCR), which incorporates all responses less than nCR that is not progressive disease. This article aims to review the clinical tools currently routinely available to evaluate treatment response and offers a potential management approach based on the extent of local tumor response.

The Effect of Width-Mismatch of Modulated Nanowaveguides on the Thermoelectric Efficiency.

Width-modulated nanowaveguides are promising for thermoelectric efficiency enhancement because electron and phonon transport properties can be geometrically tuned for improved performance. The shape of the modulation profile drastically affects the transport properties. Optimization of the width modulation for simultaneous maximum thermoelectric transport and minimum thermal transport is challenging because of the interconnected electron and phonon transport properties.

Evaluation of Medicare Reimbursement and Surgical Patterns for Male and Female Colorectal Surgeons.

Introduction: There are documented differences in salary for male and female surgeons. Understanding the differences in the clinical practice, composition of male and female surgeons may provide a better understanding of reimbursement differences. We aim to evaluate the differences of Medicare reimbursement for different categories of clinical practice for male and female colorectal surgeons.

A physics rule to design aperiodic width-modulated waveguides for minimum phonon transmission with Bayesian optimization.

Aperiodic nano-waveguides (nWVGs) and superlattices (SLs) limit phonon transmission and heat conduction much more efficiently than periodic ones. They could block parasitic heat conduction that restricts heat management and energy conversion at the nanoscale. Aperiodicity can be realized in multiple ways and with variable degrees of complexity.

Fertility and Pregnancy: How Do These Affect Family Planning and Surgeon Health?

There are unique considerations to fertility and pregnancy for women surgeons. Women surgeons often decide to delay pregnancy and childbearing due to concerns of conflict with work and training. This is particularly true for surgical trainees who face many obstacles, including bias from peers and program directors, and work-life conflict.

Supervised topological data analysis for MALDI mass spectrometry imaging applications.

Background: Matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) displays significant potential for applications in cancer research, especially in tumor typing and subtyping. Lung cancer is the primary cause of tumor-related deaths, where the most lethal entities are adenocarcinoma (ADC) and squamous cell carcinoma (SqCC). Distinguishing between these two common subtypes is crucial for therapy decisions and successful patient management.

Surgical and Interventional Management of Lung Metastasis: Surgical Assessment, Resection, Ablation, Percutaneous Interventions.

The lungs are the second most common site of metastases for colorectal cancer after the liver. Pulmonary metastases can be identified at the time of diagnosis of the primary tumor, or metachronously. About 20% of patients with colorectal cancer will develop pulmonary metastases.

Bowel Preparation for Elective Hartmann Operation: Analysis of the National Surgical Quality Improvement Program Database.

Use of pre-operative bowel preparation in colorectal resection has not been examined solely in patients who have had colorectal resection with primary colostomy (Hartmann procedure). We aimed to evaluate the association of bowel preparations with short-term outcomes after non-emergent Hartmann procedure. The National Surgical Quality Improvement Program Participant Use File colectomy database was queried for patients who had elective open or laparoscopic Hartmann operation.

A retrospective study of the effects of minimally invasive colorectal surgery on Patient Safety Indicators across a five-hospital system.

Background: The Agency for Healthcare Research and Quality uses Patient Safety Indicators (PSI) to gauge quality of care and patient safety in hospitals. PSI 90 is a weighted combination of several PSIs that primarily comprises perioperative events. This score can affect reimbursement through Medicare and hospital quality ratings.

Effect of preoperative versus postoperative use of transversus abdominis plane block with plain 0.25 % bupivacaine on postoperative opioid use: a retrospective study.

Background: Enhanced recovery protocols optimize pain control via multimodal approaches that include transversus abdominis plane (TAP) block. The aim of this study was to evaluate the effect of preoperative vs. postoperative plain 0.

Risk Factors for Surgical Site Infection After Laparoscopic Colectomy: An NSQIP Database Analysis.

Background: Surgical site infection (SSI) is a common complication after colon surgery. This study aimed to evaluate risk factors for SSI and its types in laparoscopic colectomy patients using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database.

Materials And Methods: The NSQIP database was queried for patients undergoing laparoscopic colectomy from 2011 through 2017.

Surgical Wound Misclassification to Clean From Clean-Contaminated in Common Abdominal Operations.

Background: Wound classification helps predict wound-related complications and is useful in stratifying surgical site infection reporting. We sought to evaluate misclassification among commonly performed surgeries that are at least clean-contaminated.

Materials And Methods: The National Surgical Quality Improvement Program database was queried from 2005 to 2016 by Current Procedural Terminology codes identifying common surgeries that are, by definition, not clean: colectomy, cholecystectomy, hysterectomy, and appendectomy.

Is Loop Ileostomy in Patients with Cecal Bascule a Viable Option?

Background: Cecal bascule, initially described in 1899 by Treves, is the rarest form of cecal volvulus and represents a phenomenon when a redundant and distended cecum folds anteriorly over the ascending colon causing an intestinal obstruction. Patients with cerebral palsy are at increased risk for this condition.

Case Presentation: We present a 28-year-old male with cerebral palsy, functionally dependent in all activities of daily living, who had undergone a loop ileostomy for cecal bascule.

Current Status of the Radiologic Assessment of Diverticular Disease.

Radiologic assessment plays a vital role in the management of diverticulitis. It not only helps in the diagnosis, but also helps to guide the management. As technology has progressed, different modalities have offered insight into the treatment of this disease process.

Study of bone metabolism and angiogenesis in patients undergoing high-dose chemotherapy/autologous hematopoietic stem cell transplantation.

Objectives: As the interaction between hematopoietic stem cells (HSCs) and endosteal and endothelial niches in HSCs homing is essential, we aimed to study bone turnover and angiogenesis in 29 patients with lymphoma/multiple myeloma undergoing hematopoietic stem cell transplantation (HSCT).

Methods: Serum samples were collected before high-dose chemotherapy (HDT), at the end of HDT, after HSC infusion, at the nadir of myelotoxicity, and at engraftment. Bone metabolism (CTX, TRACP-5b, bALP, OC, DKK1, RANKL, OPG), and angiogenesis (Ang1, Ang2) markers were measured.

Protein Z (PZ) and plasminogen activator inhibitor-1 (PAI-1) plasma levels in patients with previously untreated Hodgkin lymphoma (HL).

Purpose: The role of Protein Z (PZ) in conditions, such as thrombosis, inflammation or cancer, is under investigation. Plasminogen Activator Inhibitor-1 (PAI-1) is an acute phase reactant that promotes thrombosis and tumorigenesis. Subject of this work was to study PZ and PAI-1 in patients with Hodgkin Lymphoma (HL), a malignancy with inflammatory background and relatively low incidence of thrombosis.

Sample preparation issues in NMR-based plant metabolomics: optimisation for Vitis wood samples.

Introduction: Nuclear magnetic resonance (NMR) is one of the most commonly used analytical techniques in plant metabolomics. Although this technique is very reproducible and simple to implement, sample preparation procedures have a great impact on the quality of the metabolomics data.

Objective: Investigation of different sample preparation methods and establishment of an optimised protocol for untargeted NMR-based metabolomics of Vitis vinifera L.

Anorectal melanoma.

Anorectal melanoma is a disease that can be difficult to diagnose because of its unclear presentation. After diagnosis, the main treatment available is surgical resection. Sentinel lymph node mapping has an unclear role in its management.