Introductory Video as a Supplemental Application for General Surgery Residency Candidates: Concept, Implementation, Preliminary Outcomes, and Future Directions.

OBJECTIVE: The residency selection process has changed dramatically over the past several years, primarily due to the COVID-19 pandemic causing a transition to virtual interviews and limiting sub-internship opportunities. Another new major change is the transition of the USMLE Step 1 examination from a numerical score to pass/fail as of January 2022. In anticipation of this major change, our program asked applicants to submit a short video clip expressing their interest. PARTICIPANTS: Review of each of the videos was completed by three members of the admission committee and each reviewer was required to complete formal implicit bias training prior to reviewing the videos. RESULTS: Over 1200 general surgery residency applications were received via the Electronic Residency Application Service (ERAS) for the 2022-2023 application cycle. 286 applicants were selected for a formal interview invitation and asked to submit a 2-minute introductory video. In response, 222 (77.62%) of the 286 cohort submitted introductory videos. 210 of these videos (94.59%) were submitted within the first week. The average length of the videos submitted was 105.10 seconds. CONCLUSION: Using optional introductory videos as a supplemental application has helped to narrow the applicant pool and identify individuals to offer interviews.

Colonic Trichobezoar Causing Acute Large Bowel Obstruction.

A trichobezoar is a solid mass of undigested hair that accumulates in the gastrointestinal tract that is typically associated with trichotillomania and trichophagia. Most documented cases are reported to be found in the stomach and small intestine. We report a case of a complete large bowel and small bowel obstruction secondary to a trichobezoar in an 81-year-old male with abdominal pain for one month. He presented to the emergency department with sudden onset nausea, vomiting, constipation, and severe abdominal pain, prompting him to come to the emergency department. CT demonstrated a mechanical obstruction with a transition point at the splenic flexure with pneumatosis. He was taken for urgent exploratory laparotomy, where a colotomy was made and the obstructive intraluminal mass in the transverse colon was identified and removed, and a transverse colostomy was matured. Subsequent pathology revealed the mass as hair and fecal material, confirming a diagnosis of colonic obstruction due to trichobezoar.

Selective cell propagation via micropatterning of a thermally-activated hydrogel.

The ability to selectively propagate specific cells is fundamentally important to the development of clonal cell populations. Current methods rely on techniques such as limiting dilution, colony picking, and flow cytometry to transfer single cells into single wells, resulting in workflows that are low-throughput, slowed by propagation kinetics, and susceptible to contamination. Here, we developed a method, called selective laser gelation (SLG), to micropattern hydrogels in cell culture media in order to encapsulate specific cells to selectively arrest their growth. This process relies on the inverse gelation of methylcellulose, which forms a hydrogel when heated rather than cooled. Local heating using an infrared laser enables hydrogel micropatterning, while phase transition hysteresis retains the hydrogel after laser excitation. As a demonstration, we used this approach to selectively propagate transgenic CHO cells with increased antibody productivity. More generally, hydrogel micropatterning provides a simple and non-contact method for selective propagation of cells based on features identified by imaging.

Radioactive seed localization of nonpalpable breast lesions in an academic comprehensive cancer program community hospital setting.

Wire localized excision (WLE) has been a long-standing method for localization of nonpalpable breast lesions. Disadvantages of this method include difficulty locating the wire tip in relation to borders of the lesion, imprecise placement of the wire, and the need to place the wire shortly before scheduled surgery. These shortcomings may lead to a high positive margin rate requiring re-excision to obtain clear margins for breast cancer. Radioactive seed localized excision (RSLE) of nonpalpable breast lesions has been advocated as a safe and effective alternative to WLE. The primary endpoints of the study were to compare re-excision rates between WLE and RSLE of nonpalpable breast lesions and to determine if there were any differences in volume of tissue removed. One hundred three patients were included in a retrospective review of localized breast excisions done by a single surgeon. Forty-four patients underwent WLE between April 2007 and February 2009. Fifty-nine patients underwent RSLE between September 2009 and January 2012. Margins were considered to be clear if at least 1 mm of normal tissue was obtained from the circumferential periphery of the lesion in question. RSLE resulted in a re-excision rate of 17 versus 55 per cent re-excision rate for wire localization (P < 0.001). Excision volume was greater for patients having wire localization (P = 0.074). RSLE is an effective technique for excision of nonpalpable breast lesions in the community setting. This technique allows for accurate localization and appears to allow for smaller volume of tissue to be excised.