Development of Ventral Hernia Repair Curriculum Using the AWSSOM-a Synthetic Abdominal Wall Surgical Skills Operational Model.

Introduction: Ventral hernia repair cost the U.S. healthcare system nearly 3 billion dollars annually.

Developing a Translational Team Training Program using the Wisconsin Interventions in Team Science Framework.

The Clinical and Translational Science Awards (CTSA) Program supports a national network of medical research institutions working to improve the translational process. High-performing translational teams (TTs) are critical for advancing evidence-based approaches that improve human health. When focused on content-appropriate knowledge, skills, and attitudes, targeted training results in the substantial internalization of training content, producing new skills that can be applied to improve team outputs, outcomes, and benefits.

A leadership model supporting maturation of high-performance translational teams.

Despite understanding its impact on organizational effectiveness, practical guidance on how to train translational team (TT) leaders is lacking. Previously, we developed an evolutionary learning model of TT maturation consisting of three goal-directed phases: (1). team assembly (); (2).

Development and Implementation of Urologic Care Army/Air Force/Navy Provider Education, a Urologic Emergency Simulation Curriculum.

Background: Military general surgeons commonly perform urologic procedures, yet, there are no required urologic procedural minimums during general surgery residency training. Additionally, urologists are not included in the composition of forward operating surgical units. Urologic Care Army/Air Force/Navy Provider Education was created to provide military general surgeons with training to diagnose and treat frequently encountered urologic emergencies when practicing in environments without a urologist present.

Coherent perfect absorption at an exceptional point.

Recently, exceptional points, a degeneracy of open wave systems, have been observed in photonics, acoustics, and electronics. They have mainly been realized as a degeneracy of resonances; however, a degeneracy associated with the absorption of waves can exhibit distinct and interesting physical features. Here, we demonstrate such an absorbing exceptional point by engineering degeneracies in the absorption spectrum of dissipative optical microcavities.

Early implementation of Fundamentals of Endoscopic Surgery training using a simulation-based mastery learning curriculum.

Background: After the American Board of Surgery announcement of the Flexible Endoscopy Curriculum requirement in 2014, we implemented a dedicated endoscopy rotation at the post graduate year (PGY)2 level including a simulation curriculum for Fundamentals of Endoscopic Surgery skills. Here we evaluate the outcomes of this implementation.

Methods: Beginning in 2015, we developed a clinical endoscopy and simulation-based rotation to prepare for Fundamentals of Endoscopic Surgery testing.

Induced transparency by interference or polarization.

Polarization of optical fields is a crucial degree of freedom in the all-optical analogue of electromagnetically induced transparency (EIT). However, the physical origins of EIT and polarization-induced phenomena have not been well distinguished, which can lead to confusion in associated applications such as slow light and optical/quantum storage. Here we study the polarization effects in various optical EIT systems.

Fundamentals of Anorectal Technical Skills: A Concise Surgical Skills Course.

Introduction: Anorectal diseases, among the most common surgical conditions, are underrepresented in medical training. The Fundamentals of Anorectal Technical Skills course was developed to provide cost-effective formal training in diagnosis of common anorectal conditions and in commonly performed anorectal procedures using the theories of deliberative practice and perceptual and adaptive learning.

Materials And Methods: First- through third-year general surgery and internal medicine residents and third- and fourth-year medical students participated in a course consisting of didactic instruction and hands on skills stations.

Quantum Noise Theory of Exceptional Point Amplifying Sensors.

Open quantum systems can have exceptional points (EPs), degeneracies where both eigenvalues and eigenvectors coalesce. Recently, it has been proposed and demonstrated that EPs can enhance the performance of sensors in terms of amplification of a detected signal. However, typically amplification of signals also increases the system noise, and it has not yet been shown that an EP sensor can have improved signal-to-noise performance.

Attrition Rate in Military General Surgery GME and Effect on Quality of Military Programs.

Introduction: The attrition rate in civilian general surgery Graduate Medical Education (GME) is estimated at 20%, while estimates of attrition in military general surgery (MGS) GME programs using the same methodology are nearly twice that. We sought to identify the true attrition rate in MGS GME, identify factors influencing attrition, and examine the relationship between attrition and quality of MGS GME.

Methods: Deidentified data were collected on categorical general surgery residents matriculating from 2010 to 2013 from all 12 MGS residency programs.

Surgery at Sea: Exploring the Training Gap for Isolated Military Surgeons.

Objective: Newly-graduated military general surgeons often find themselves isolated at sea, solely responsible for all surgical care of several thousand sailors, regardless of the surgical specialty training required for any individual procedure. This educational need assessment explored trends in afloat surgical care over the last 25 years, and assessed trainees' preparedness for their expected role as an isolated surgeon.

Design: A sample of deidentified US Navy Ship's Surgeon case logs were reviewed to determine afloat case load trends in 5 common afloat case categories (urologic/gynecologic, anorectal, hernia, appendectomy, and hand/orthopedic/trauma) from 1990s to 2017.

Perfectly Absorbing Exceptional Points and Chiral Absorbers.

We identify a new kind of physically realizable exceptional point (EP) corresponding to degenerate coherent perfect absorption, in which two purely incoming solutions of the wave operator for electromagnetic or acoustic waves coalesce to a single state. Such non-Hermitian degeneracies can occur at a real-valued frequency without any associated noise or nonlinearity, in contrast to EPs in lasers. The absorption line shape for the eigenchannel near the EP is quartic in frequency around its maximum in any dimension.

Fasciotomy Improvement Through Recognition of Errors Course: A Focused Needs Assessment for Error Management Training for Lower Extremity Fasciotomy Performance.

Background: Many injuries from recent wars involve extremity trauma secondary to blasts, which predispose patients to developing extremity compartment syndrome. In military studies, 17% of fasciotomies required revision on arrival to a Role 4 hospital, and 41% of these had missed compartments, which is similar to that seen in civilian centers. While training has decreased this rate to 8%, this number is still too high.

Unique interstitial miRNA signature drives fibrosis in a murine model of autosomal dominant polycystic kidney disease.

Aim: To delineate changes in miRNA expression localized to the peri-cystic local microenvironment (PLM) in an orthologous mouse model of autosomal dominant polycystic kidney disease (ADPKD) ( ).

Methods: We profiled miRNA expression in the whole kidney and laser captured microdissection (LCM) samples from PLM in kidneys with Qiagen miScript 384 HC miRNA PCR arrays. The three times points used are: (1) post-natal (PN) day 21, before the development of trichrome-positive areas; (2) PN28, the earliest sign of trichrome staining; and (3) PN42 following the development of progressive fibrosis.

Double-Opposing Z-Plasty for Secondary Surgical Management of Velopharyngeal Insufficiency Following Primary Furlow Palatoplasty.

Objective: The present study investigates the efficacy of performing a "palate rerepair" utilizing a double-opposing z-palatoplasty (DOZ) following primary Furlow palatoplasty.

Design: Retrospective study.

Setting: Tertiary referral academic center for craniofacial surgery.

Tesevatinib ameliorates progression of polycystic kidney disease in rodent models of autosomal recessive polycystic kidney disease.

Aim: To investigate the therapeutic potential of tesevatinib (TSV), a unique multi-kinase inhibitor currently in Phase II clinical trials for autosomal dominant polycystic kidney disease (ADPKD), in well-defined rodent models of autosomal recessive polycystic kidney disease (ARPKD).

Methods: We administered TSV in daily doses of 7.5 and 15 mg/kg per day by I.

Emerging Therapies for Childhood Polycystic Kidney Disease.

Cystic kidney diseases comprise a varied collection of hereditary disorders, where renal cysts comprise a major element of their pleiotropic phenotype. In pediatric patients, the term polycystic kidney disease (PKD) commonly refers to two specific hereditary diseases, autosomal recessive polycystic kidney disease (ARPKD) and autosomal dominant polycystic kidney disease (ADPKD). Remarkable progress has been made in understanding the complex molecular and cellular mechanisms of renal cyst formation in ARPKD and ADPKD.

Location is everything: The role of splenic flexure mobilization during colon resection for diverticulitis.

Introduction: Routine splenic flexure mobilization (SFM) has been previously recommended to ensure an adequate length for a tension free anastomosis during resection for diverticulitis. We sought to evaluate the role of selective SFM for diverticulitis, and its impact on outcomes.

Materials And Methods: Retrospective review of elective colectomies at a tertiary care center (2007-2015) for left-sided diverticulitis were identified from the National Surgical Quality Improvement Program.

Characterizing Short-Term Outcomes Following Surgery for Rectal Cancer: the Role of Race and Insurance Status.

Background: There is a paucity of data demonstrating the effect race and insurance status have on postoperative outcomes for patients with rectal cancer. We evaluated factors impacting short-term outcomes following rectal cancer surgery.

Design: Patients who underwent surgery for rectal cancer using the University Health System Consortium database from 2011 to 2012 were studied.

Surgeon Volume Correlates with Reduced Mortality and Improved Quality in the Surgical Management of Diverticulitis.

Background: Volume has been shown to be an important determinant of quality and cost outcomes.

Methods: We performed a retrospective study of patients who underwent surgery for diverticulitis using the University HealthSystem Consortium database from 2008–2012. Outcomes evaluated included minimally invasive approach, stoma creation, intensive-care admission, post-operative complications, length of stay, and total direct hospital costs by surgeon volume.