Increasing Social Media Presence for Graduate Medical Education Programs.

Virtual residency interviews during COVID-19 pandemic created a need for residency programs to use social media to increase their visibility and connect with potential applicants. This was, however, new and a road never travelled for many programs. This report describes how our General Surgery Residency Program increased its presence through social media by using various exposure methods and approaches, including diversifying presence and developing candid personalized content. Results suggest that these methods have increased our exposure and reach from an average of 7 people per post to posts reaching over 4500 people. Moreover, the video posts introducing our residents and faculty provided the highest activity and reach. Thus, appropriate use of social media with described interventions and new content creation could exponentially increase the visibility of a residency program. Moreover, educating faculty and residents on the use and importance of social media could increase their interest and participation as well.

Haploinsufficiency of Shank3 increases the orientation selectivity of V1 neurons.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder whose hallmarks are social deficits, language impairment, repetitive behaviors, and sensory alterations. It has been reported that patients with ASD show differential activity in cortical regions, for instance, increased neuronal activity in visual processing brain areas and atypical visual perception compared with healthy subjects. The causes of these alterations remain unclear, although many studies demonstrate that ASD has a strong genetic correlation. An example is Phelan-McDermid syndrome, caused by a deletion of the Shank3 gene in one allele of chromosome 22. However, the neuronal consequences relating to the haploinsufficiency of Shank3 in the brain remain unknown. Given that sensory abnormalities are often present along with the core symptoms of ASD, our goal was to study the tuning properties of the primary visual cortex to orientation and direction in awake, head-fixed Shank3+/- mice. We recorded neural activity in vivo in response to visual gratings in the primary visual cortex from a mouse model of ASD (Shank3+/- mice) using the genetically encoded calcium indicator GCaMP6f, imaged with a two-photon microscope through a cranial window. We found that Shank3+/- mice showed a higher proportion of neurons responsive to drifting gratings stimuli than wild-type mice. Shank3+/- mice also show increased responses to some specific stimuli. Furthermore, analyzing the distributions of neurons for the tuning width, we found that Shank3+/- mice have narrower tuning widths, which was corroborated by analyzing the orientation selectivity. Regarding this, Shank3+/- mice have a higher proportion of selective neurons, specifically neurons showing increased selectivity to orientation but not direction. Thus, the haploinsufficiency of Shank3 modified the neuronal response of the primary visual cortex.

Thriving in the Virtual Era: An Organized Approach to Improve Program Visibility and Virtual Residency Interview Process.

OBJECTIVE: Since residency interviews became virtual due to COVID-19, and likely continue in the future, programs must find ways to improve their non-traditional recruiting methods. The objective of this study was to evaluate effectiveness of a structured, non-traditional approach on visibility and perception of the program as well as virtual interview experience. METHODS: The focus of our approach was to ensure constant engagement while maintaining all pre-interview communication as resident-led and informal. The program focused on improving visibility and outreach through an organized utilization of social media platforms highlighting people and local culture. The virtual interview process was restructured with resident-led virtual meet and greets followed by small group discussions and providing virtual hospital tours, videos, and slides of the program's culture and expectationson the interview day. Perception of the program and the new approach to the interview process was assessed via an anonymous survey. RESULTS: The program's visibility was measured via social media analytics with an increase in reach on Facebook from 0/post to as high as 4200/post and engagement 2/post to nearly 600/post. Tweet Impressions from approximately 350/mo to 11,000/mo with the increase in new Followers/month by 532.5%. Increase in total number of applicants in 2021 of 16% compared to average between 2018 and 2020. Survey response rate was 66.1%; of those 53.8% of interviewees attended a virtual meet and greet session. Perceptions of interviewees on our program was exclusively positive. Specific characteristics of the program that would make students rank us higher were program's culture, people, academics, and clinical experiences they would get as residents. CONCLUSIONS: The exponential increase in our program's visibility and exclusively positive program assessment suggest that a structured approach utilizing social media and virtual technologies could improve both the recruitment and the virtual interview process while maintaining positive perceptions of the program.

Association between COVID-19 related elective surgery cancellations and pediatric inguinal hernia complications: A nationwide multicenter cohort study.

BACKGROUND: Optimal inguinal hernia repair timing remains controversial. It remains unclear how COVID-19 related elective surgery cancellations impacted timing of inguinal hernia repair and whether any delays led to complications. This study aims to determine whether elective surgery cancellations are safe in pediatric inguinal hernia. METHODS: This multicenter retrospective cohort study at 14 children's hospitals included patients ≤18 years who underwent inguinal hernia repair between September 13, 2019, through September 13, 2020. Patients were categorized by whether their inguinal hernia repair occurred before or after their hospital's COVID-19 elective surgery cancellation date. Incarceration and emergency department encounters were compared between pre and postcancellation. RESULTS: Of 1,404 patients, 604 (43.0%) underwent inguinal hernia repair during the postcancellation period, 92 (6.6%) experienced incarceration, and 213 (15.2%) had an emergency department encounter. The postcancellation period was not associated with incarceration (odds ratio 1.54; 95% confidence interval 0.88-2.71; P = .13) or emergency department encounters (odds ratio 1.53; 95% confidence interval 0.94-2.48; P = .09) despite longer median times to inguinal hernia repair (precancellation 29 days [interquartile range 13-55 days] versus postcancellation 31 days [interquartile range 14-73 days], P = .01). Infants were more likely to have the emergency department be their index presentation in the postcancellation period (odds ratio 1.69; 95% confidence interval 1.24-2.31; P < .01). CONCLUSION: Overall, COVID-19 elective surgery cancellations do not appear to increase the likelihood of incarceration or emergency department encounters despite delays in inguinal hernia repair, suggesting that cancellations are safe in children with inguinal hernia. Assessment of elective surgery cancellation safety has important implications for health policy.

Diagnostic Laparoscopy for Abdominal Trauma in Infants and Children: How We Do It.

Although once thought to be a point of contention, the use of minimally invasive surgery for the hemodynamically stable pediatric trauma patients has grown dramatically since its conception in the 1970s and becoming a widely acceptable option for select patient populations. An accumulation of literature over the decades has continued to support laparoscopy for both diagnostic and therapeutic purposes in the pediatric trauma patients as laparoscopy is likely to decrease morbidity, hospital cost, and negative laparotomy rates. In this review, we describe what we believe to be the critical aspects of diagnostic laparoscopy in the setting of pediatric trauma.

Surgical telementoring: Feasibility, applicability, and how to.

Surgical training does not end at the conclusion of residency training. Expansions in medical technology and surgical technique have created a steep learning curve for the young attending surgeon. The emergence of intraoperative telementoring has allowed experienced surgeons to guide learners through complex surgical cases remotely with the assistance of streaming video technology. Here, we describe the basics of telementoring, financial and legal considerations, and recommend hardware specifications for optimal use.

Virtual Education in Pediatric Surgery during the COVID-19 Era: Facing and Overcoming Current Challenges.

The novel coronavirus disease 2019 (COVID-19) pandemic has impacted our way of living in an unprecedented manner. Medical professionals at all levels have been forced to adapt to the novel virus. The delivery of surgical services and the subsequent learning opportunities for surgical residents have especially been disrupted and the pediatric surgical community has not been exempted by this. This article highlights the challenges imposed by the pandemic and outlines the various learning modalities that can be implemented to ensure continued learning opportunities throughout the pandemic and beyond. Furthermore, it aims to show how the utilization and expansion of technologies maintain and further increase the communication, as well as the exchange of and access to knowledge among peers. Virtual education-, application-, and simulation-based learning and social media, as well as telemedicine and online conferences, will play a considerable role in the future of surgical specialties and surgical education.

Relevancia del antecedente de absceso perirrenal en pacientes sometidos a nefrectomía simple retroperitoneal / Relevance of Perirenal Abscess in Patients undergoing Retroperitoneal Simple Nephrectomy

Las infecciones supurativas del riñón y del espacio perinefrítico son poco comunes, sin embargo, se asocian a una morbimortalidad elevada, afectando a ambos sexos por igual excepto los casos de absceso cortical que es 3 veces más común en el hombre que en la mujer. La incidencia se incrementa con la edad y habitualmente se asocia a uropatía obstructiva. Los abscesos renales representan 0,2% de todos los abscesos intraabdominales, de los cuales el 10% de los abscesos corticales rompen a través de la cápsula formando un absceso perinefrítico, el cual es difícil de manejar y conlleva un peor pronóstico, con una alta mortalidad a pesar de tratamiento quirúrgico oportuno

Supurative infections of the kidney and perinephritic space are rare, however, are associated with high morbidity and mortality, affecting both sexes equally except for cases of cortical abscess which is 3 times more common in men than in women. The incidence increases with age and is usually associated with obstructive uropathy. Renal abscesses represent 0.2% of all abscesses. intraabdominal, of which 10% of cortical abscesses break through the capsule forming a Perinephritic abscess, which is difficult to manage and leads to a worse prognosis, with high mortality despite prompt surgical treatment.

[Comparison of results of open simple nephrectomy secondary to lithiasis in patients with and without nephrostomy]. / Comparación de los resultados de la nefrectomía simple abierta secundaria a litiasis en pacientes con y sin nefrostomía.

BACKGROUND: Simple nephrectomy is the procedure of choice in the treatment of excluded kidneys. The purpose of this study was to describe and compare surgical results in open simple retroperitoneal nephrectomies in patients with and without nephrostomy. METHODOLOGY: 58 patients were analyzed. The demographic parameters of patients with nephrostomy were compared to patients without nephrostomy (age, gender, weight, lithium localization, transoperative variables (surgical time, transoperative bleeding) and postoperative variables (need for intensive care, need for transfusion, surgical wound infection and hospital stay days) RESULTS: Statistically significant differences were found for the variables of operative bleeding (p=0.0442), surgical time (p=0.0093), hospital stay days (p=0.0040), and transfusion requirements (p=0.0170). There were no differences in the need for intensive care (p=0.6314), transoperative complications (p=0.7414) and surgical wound infection (p=0.2762). CONCLUSIONS: The presence of a nephrostomy catheter in patients undergoing open simple nephrectomy leads to an increased risk of morbidity, with increased bleeding, surgical time, need for transfusion, and hospital stay days.

Vascular endothelial growth factor influences migration and focal adhesions, but not proliferation or viability, of human neural stem/progenitor cells derived from olfactory epithelium.

In humans, new neurons are continuously added in the olfactory epithelium even in the adulthood. The resident neural stem/progenitor cells (hNS/PCs-OE) in the olfactory epithelium are influenced by several growth factors and neurotrophins. Among these modulators the vascular endothelial growth factor (VEGF) has attracted attention due its implicated in cell proliferation, survival and migration of other type of neural/stem progenitor cells. Interestingly, VEGFr2 receptor expression in olfactory epithelium has been described in amphibians but not in humans. Here we show that VEGFr is expressed in the hNS/PCs-OE. We also investigated the effect of VEGF on the hNS/PCs-OE proliferation, viability and migration in vitro. Additionally, pharmacological approaches showed that VEGF (0.5 ng/ml)-stimulated migration of hNS/PCs-OE was blocked with the compound DMH4, which prevents the activation of VEGFr2. Similar effects were found with the inhibitors for Rac (EHT1864) and p38MAPK (SB203850) proteins, respectively. These observations occurred with changes in focal adhesion contacts. However, no effects of VEGF on proliferation or viability were found in hNS/PCs-OE. Our results suggest that hNS/PCs-OE respond to VEGF involving VEGFr2, Rac and p38MAPK.