MEETING HIGHLIGHTS: THE THIRD MARIE SKLODOWSKA-CURIE SYMPOSIUM ON CANCER RESEARCH AND CARE AT ROSWELL PARK COMPREHENSIVE CANCER CENTER, BUFFALO, NY, SEPTEMBER 20-22, 2023.

Marie Sklodowska-Curie Symposia on Cancer Research and Care (MSCS-CRC) promote collaborations between cancer researchers and care providers in the United States, Canada and Central and Eastern European Countries (CEEC), to accelerate the development of new cancer therapies, advance early detection and prevention, increase cancer awareness, and improve cancer care and the quality of life of patients and their families. The third edition of MSCS-CRC, held at Roswell Park Comprehensive Cancer Center, Buffalo, NY, in September 2023, brought together 137 participants from 20 academic institutions in the US, Poland, Ukraine, Lithuania, Croatia and Hungary, together with 16 biotech and pharma entities. The key areas of collaborative opportunity identified during the meeting are a) creating of a database of available collaborative projects in the areas of early-phase clinical trials, preclinical development, and identification of early biomarkers; b) promoting awareness of cancer risks and efforts at cancer prevention; c) laboratory and clinical training; and d) sharing experience in cost-effective delivery of cancer care and improving the quality of life of cancer patients and their families. Examples of ongoing international collaborations in the above areas were discussed. Participation of the representatives of the Warsaw-based Medical Research Agency, National Cancer Institute (NCI) of the United States, National Cancer Research Institutes of Poland and Lithuania, New York State Empire State Development, Ministry of Health of Ukraine and Translational Research Cancer Center Consortium of 13 cancer centers from the US and Canada, facilitated the discussion of available governmental and non-governmental funding initiatives in the above areas.

Sensitivity Analysis of Determining the Material Parameters of an Asphalt Pavement to Measurement Errors in Backcalculations.

Nondestructive tests of road pavements are among the most widely used methods of pavement condition diagnostics. Deflections of road pavement under a known load are most commonly measured in such tests, e.g., with the use of falling weight deflectometer (FWD). Measured values allow to determine the material parameters of the road structure, corresponding to the obtained results, by means of backcalculations. Among the factors that impact on the quality of results is the accuracy of deflection measurement. Deflection basins with small differences of displacement values may correspond to significantly different combinations of material parameters. Taking advantage of them for mechanistic calculations of road pavement may eventually lead to incorrect estimation of the remaining fatigue life and then inadequate selection of pavement reinforcement. This study investigated the impact of measurement errors on the change of the obtained values of stiffness moduli of flexible road pavement layers. Additionally, the influence of obtained material parameters on the values of key pavement strain, and consequently on its design fatigue life was presented.

High Entrainment Constrains Synaptic Depression Levels of an In vivo Globular Bushy Cell Model.

Globular bushy cells (GBCs) located in the ventral cochlear nucleus are an essential part of the sound localization pathway in the mammalian auditory system. They receive inputs directly from the auditory nerve and are particularly sensitive to temporal cues due to their synaptic and membrane specializations. GBCs act as coincidence detectors for incoming spikes through large synapses-endbulbs of Held-which connect to their soma. Since endbulbs of Held are an integral part of the auditory information conveying and processing pathway, they were extensively studied. Virtually all in vitro studies showed large synaptic depression, but on the other hand a few in vivo studies showed relatively small depression. It is also still not well understood how synaptic properties functionally influence firing properties of GBCs. Here we show how different levels of synaptic depression shape firing properties of GBCs in in vivo-like conditions using computer simulations. We analyzed how an interplay of synaptic depression (0-70%) and the number of auditory nerve fiber inputs (10-70) contributes to the variability of the experimental data from previous studies. We predict that the majority of synapses of GBCs with high characteristic frequencies (CF > 500 Hz) have a rate dependent depression of less than 20%. GBCs with lower CF (<500 Hz) work also with strong depressing synapses (up to 50% or more). We also showed that synapses explicitly fitted to in vitro experiments with paired-pulse stimuli did not operate properly in in vivo-like conditions and required further extension to capture the differences between in vitro and in vivo experimental conditions. Overall, this study helps to understand how synaptic properties shape temporal processing in the auditory system. It also integrates, compares, and reconciles results of various experimental studies.

[Polonia Medyczna: struktura, wspólczesnosc i przyszlosc].

It is estimated that approximately 20-25 000 polish physicians practice medicine in different countries outside of Poland, enriching medical workforces in their newly elected countries. The composition of this group, known as "Medical Polonia", has been changing from post Second World War emigration, resulting from the war and its political consequences, thru the next large wave of physicians leaving the communist country in 1980's. The last large group of Polish physicians has taken advantage of training opportunities or have started practices in the European Union, having departed Poland permanently or temporarily, after the country joined the European Union in 2004. The first organizations of Polish physicians outside of Poland were founded almost immediately after WWII in London, Chicago, New York, Paris, Lille, and later in Stockholm. Decades later, re-invigorated by their native country gaining independence after 1989, they organized the first World Congress of Medical Polonia in 1991 (in collaboration with physicians' organization from Poland). The World Federation of Polish Medical Organization Abroad was then established in 1994. Subsequently, many organizations joined the Federation, including several from newly liberated countries of former Soviet Union. The Federation of Polish Medical Organizations and its member societies actively promotes medical education, collaboration between polish doctors all over the world, and the exchange of ideas-sharing experiences with significant emphasis on the quality of care and patient safety.

Expected and Unexpected Consequences of the Affordable Care Act: The Impact on Patients and Surgeons-Pro and Con Arguments.

The Patient Protection and Affordable Care Act (PPACA), called the Affordable Care Act (ACA) or "ObamaCare" for short, was enacted in 2010. The Public Policy and Advocacy Committee of the Society for Surgery of the Alimentary Tract (SSAT) hosted a debate with an expert panel to discuss the ACA and its impact on surgical care after the first year of patient enrollment. The purpose of this debate was to focus on the impact of ACA on the public and surgeons. At the core of the ACA are insurance industry reforms and expanded coverage, with a goal of improved clinical outcomes and reduced costs of care. We have observed supportive and opposing views on ACA. Nonetheless, we will witness major shifts in health care delivery as well as restructuring of our relationship with payers, institutions, and patients. With the rapidly changing health care landscape, surgeons will become key members of health systems and will likely need to lead transition from solo-practice to integrated care systems. The full effects of the ACA remain unrealized, but its implementation has begun to change the map of the American health care system and will surely impact the practice of surgery. Herein, we provide a synopsis of the "pro" and "con" arguments for the expected and unexpected consequences of the ACA on society and surgeons.

Modeling auditory coding: from sound to spikes.

Models are valuable tools to assess how deeply we understand complex systems: only if we are able to replicate the output of a system based on the function of its subcomponents can we assume that we have probably grasped its principles of operation. On the other hand, discrepancies between model results and measurements reveal gaps in our current knowledge, which can in turn be targeted by matched experiments. Models of the auditory periphery have improved greatly during the last decades, and account for many phenomena observed in experiments. While the cochlea is only partly accessible in experiments, models can extrapolate its behavior without gap from base to apex and with arbitrary input signals. With models we can for example evaluate speech coding with large speech databases, which is not possible experimentally, and models have been tuned to replicate features of the human hearing organ, for which practically no invasive electrophysiological measurements are available. Auditory models have become instrumental in evaluating models of neuronal sound processing in the auditory brainstem and even at higher levels, where they are used to provide realistic input, and finally, models can be used to illustrate how such a complicated system as the inner ear works by visualizing its responses. The big advantage there is that intermediate steps in various domains (mechanical, electrical, and chemical) are available, such that a consistent picture of the evolvement of its output can be drawn. However, it must be kept in mind that no model is able to replicate all physiological characteristics (yet) and therefore it is critical to choose the most appropriate model-or models-for every research question. To facilitate this task, this paper not only reviews three recent auditory models, it also introduces a framework that allows researchers to easily switch between models. It also provides uniform evaluation and visualization scripts, which allow for direct comparisons between models.

Robotic versus laparoscopic cholecystectomy inpatient analysis: does the end justify the means?

BACKGROUND AND OBJECTIVES: Robotic-assisted cholecystectomy (RAC) was introduced several years ago. With its more extensive use by surgeons, more information is needed regarding clinical and economic outcomes. METHODS: The Nationwide Inpatient Sample from the Health Cost Utilization Project was analyzed using HCUPnet, National Inpatient Sample (NIS) datasets and SAS 9.2 for the years 2010-2011. Queries were made for RAC and laparoscopic cholecystectomy (LC) procedures with a primary diagnosis of gallbladder disease. Overall charges, costs, number of chronic conditions, comorbidities, and length of stay were calculated. RESULTS: RAC was $7518, +54 % (p < 0.05), and $4044, +29 % (p < 0.05), more costly compared to LC in 2010 and 2011, respectively. Total costs for RAC decreased by 14.6 % (p = 0.27) between 2010 and 2011, even though RAC was still costlier than LC in 2011. There was no significant difference in the LOS between RAC and LC in either years. Patients undergoing RAC had an increased number of chronic conditions compared to patients undergoing LC in both 2010 and 2011. CONCLUSION: LOS of RAC is similar to LC. Cost of RAC remains higher compared to LC although there was reduction in cost of RAC in 2011 versus 2010.

Staying alive: strategies for accountable health care.

The Patient Protection and Affordable Care Act signed into law in March 2010, has led to sweeping changes to the US health care system. The ensuing pace of change in health care regulation is unparalleled and difficult for physicians to keep up with. Because of the extraordinary challenges that have arisen, the public policy committee of the Society for Surgery of the Alimentary tract conducted a symposium at their 52nd Annual Meeting in May 2011 to educate participants on the myriad of public policy changes occurring in order to best prepare them for their future. Expert speakers presented their views on policy changes affecting diverse areas including patient safety, patient experience, hospital and provider fiscal challenges, and the life of the practicing surgeon. In all areas, surgical leadership was felt to be critical to successfully navigate the new health care landscape as surgeons have a long history of providing safe, high quality, low cost care. The recognition of shared values among the diverse constituents affected by health care policy changes will best prepare surgeons to control their own destiny and successfully manage new challenges as they emerge.

A priori dietary omega-3 lipid supplementation results in local pancreatic macrophage and pulmonary inflammatory response attenuation in a model of experimental acute edematous pancreatitis (AEP).

BACKGROUND: Acute pancreatitis is often complicated by multiorgan dysfunction, which is postulated to occur in part by macrophage infiltration into the pancreas. Eicosapentaenoic acid (EPA), an omega-3 fatty acid, is the principal biologic component of fish oil and has clinically and experimentally been demonstrated to be anti-inflammatory. We hypothesized that dietary EPA supplementation before the induction of pancreatitis would attenuate both M-mediated local pancreatic and systemic pulmonary inflammatory response in an in vivo model of acute edematous pancreatitis (AEP). METHODS: Male Sprague-Dawley (SD) rats were pretreated 2 times per day with oral gavage with EPA (omega-3 fatty acid; 5 mg/kg/dose) or omega-6 fatty acid control (5 mg/kg/dose) or saline (equal volume) for 2 weeks. AEP was induced in omega-3, omega-6, and saline pretreated rats by 5 hourly subcutaneous (SC) injections of cerulein. Pancreas, lung, and serum were harvested 3 hours after the last cerulein injection. Severity of pancreatitis was confirmed by serum amylase and by histopathologic score. Pancreatic macrophage infiltration was assessed by confocal fluorescent microscopy, and pulmonary leukocyte respiratory burst (LRB) analysis was performed on mononuclear cells obtained from bronchioalveolar lavage (BAL). RESULTS: All animals demonstrated acute pancreatitis through hyperamylasemia and histopathologic examination. Confocal analysis demonstrated significantly lower macrophage infiltration, and BAL analysis by flow cytometry demonstrated significantly lower (p < .05) LRB in the omega-3-treated group compared with the omega-6 and the saline pancreatitis group. CONCLUSIONS: Attenuation of both pancreatic MPhi inflammatory response and pulmonary leukocyte respiratory burst in AEP by EPA supports further investigation into the potential role for EPA dietary supplementation in the progression of pancreatitis-associated sequelae.