Direct Peritoneal Resuscitation (DPR) Improves Acute Physiology and Chronic Health Evaluation (APACHE) IV and Acute Physiology Score When Used in Damage Control Laparotomies: Prospective Cohort Study on 37 Patients.

Introduction: Using direct peritoneal resuscitation (DPR) as an adjunct when managing patients undergoing damage control laparotomy (DCL) shows promising results. We report our initial experience in utilizing DPR when managing patients who underwent DCL for emergent surgery at the index operation.

Materials And Methods: We prospectively collected data on 37 patients between August 2020 to October 2021 who underwent DCL with open abdomens after the index operation and utilized DPR.

Anatomy and relationships of the early diverging Crocodylomorphs Junggarsuchus sloani and Dibothrosuchus elaphros.

The holotype of Junggarsuchus sloani, from the Shishugou Formation (early Late Jurassic) of Xinjiang, China, consists of a nearly complete skull and the anterior half of an articulated skeleton, including the pectoral girdles, nearly complete forelimbs, vertebral column, and ribs. Here, we describe its anatomy and compare it to other early diverging crocodylomorphs, based in part on CT scans of its skull and that of Dibothrosuchus elaphros from the Early Jurassic of China. Junggarsuchus shares many features with a cursorial assemblage of crocodylomorphs, informally known as "sphenosuchians," whose relationships are poorly understood.

Electronic Cigarettes: Common Questions and Answers.

Electronic cigarettes (e-cigarettes) are popular devices designed to heat a liquid solution, often containing nicotine, that generates an inhaled aerosol, or vapor. e-Cigarettes have been marketed as healthier alternatives to traditional cigarettes. Thus, most adult users are current or former smokers who use e-cigarettes to reduce or quit cigarette smoking.

The benefit (and cost) of drawing as an encoding strategy.

Drawing, as an encoding strategy for to-be-remembered words, has previously been shown to provide robust memory benefits. In the current study, we investigated the effect of drawing on false memory endorsements during a recognition test. We found that while drawing led to higher hit rates relative to writing (Experiment 1) and creating visual mental imagery (Experiment 2), it also led to higher false alarm (FA) rates to critical lures in a variant of the Deese-Roediger-McDermott (DRM) paradigm.

Making time: Estimation of internally versus externally defined durations.

Most research on the topic of duration estimation has examined the mechanisms underlying estimation of durations that are demarcated by experimental stimuli. It is not clear whether the estimation of durations that are instead defined by our own mental processes (e.g.

Automated robot-assisted surgical skill evaluation: Predictive analytics approach.

Background: Surgical skill assessment has predominantly been a subjective task. Recently, technological advances such as robot-assisted surgery have created great opportunities for objective surgical evaluation. In this paper, we introduce a predictive framework for objective skill assessment based on movement trajectory data.

Bioimpedance monitoring of cellular hydration during hemodialysis therapy.

Introduction The aim of this paper is to describe and demonstrate how a new bioimpedance analytical procedure can be used to monitor cellular hydration of End Stage Renal Disease (ESRD) patients during hemodialysis (HD). Methods A tetra-polar bioimpedance spectroscope (BIS), (UFI Inc., Morro Bay, CA), was used to measure the tissue resistance and reactance of the calf of 17 ESRD patients at 40 discrete frequencies once a minute during dialysis treatment.

Distance-based time series classification approach for task recognition with application in surgical robot autonomy.

Background: Robotic-assisted surgery allows surgeons to perform many types of complex operations with greater precision than is possible with conventional surgery. Despite these advantages, in current systems, a surgeon should communicate with the device directly and manually. To allow the robot to adjust parameters such as camera position, the system needs to know automatically what task the surgeon is performing.

Future Supply of Pediatric Surgeons: Analytical Study of the Current and Projected Supply of Pediatric Surgeons in the Context of a Rapidly Changing Process for Specialty and Subspecialty Training.

Objective: To describe the future supply and demand for pediatric surgeons using a physician supply model to determine what the future supply of pediatric surgeons will be over the next decade and a half and to compare that projected supply with potential indicators of demand and the growth of other subspecialties.

Background: Anticipating the supply of physicians and surgeons in the future has met with varying levels of success. However, there remains a need to anticipate supply given the rapid growth of specialty and subspecialty fellowships.

Understanding the Operative Experience of the Practicing Pediatric Surgeon: Implications for Training and Maintaining Competency.

Importance: The number of practicing pediatric surgeons has increased rapidly in the past 4 decades, without a significant increase in the incidence of rare diseases specific to the field. Maintenance of competency in the index procedures for these rare diseases is essential to the future of the profession.

Objective: To describe the demographic characteristics and operative experiences of practicing pediatric surgeons using Pediatric Surgery Board recertification case log data.

Task analysis of laparoscopic camera control schemes.

Background: Minimally invasive surgeries rely on laparoscopic camera views to guide the procedure. Traditionally, an expert surgical assistant operates the camera. In some cases, a robotic system is used to help position the camera, but the surgeon is required to direct all movements of the system.

The surgeon and the child.

For many reasons pediatric surgeons have been asked to do all general and thoracic procedures in children. The profession has responded by training more, but the core of special cases requiring pediatric surgical expertise has not changed, and there is concern that the many surgeons now in training will not each do enough cases to attain and maintain operative expertise. This presentation examines the psychological, educational, and surgical literature on the development of expertise, especially operative expertise.

Timing of optimal surgical intervention for neonates with necrotizing enterocolitis.

Up to half of all patients with necrotizing enterocolitis require acute surgical treatment. Determining when to operate on these patients can be challenging. Utilizing a combination of clinical and metabolic indicators, we sought to identify the optimal timing of surgical intervention.

Looking and listening: A comparison of intertrial repetition effects in visual and auditory search tasks.

Previous research shows that performance on pop-out search tasks is facilitated when the target and distractors repeat across trials compared to when they switch. This phenomenon has been shown for many different types of visual stimuli. We tested whether the effect would extend beyond visual stimuli to the auditory modality.

Raman spectroscopy in the diagnosis of ulcerative colitis.

Introduction: At present, the diagnosis of ulcerative colitis (UC) requires the histologic demonstration of characteristic mucosal inflammatory changes. A rapid and noninvasive diagnosis would be of value, especially if it could be adapted to a simple rectal probe. Raman spectroscopy creates a molecular fingerprint of substances by detecting laser light scattered from asymmetric, vibrating, and chemical bonds.

Referral to pediatric surgical specialists.

The American Academy of Pediatrics, with the collaboration of the Surgical Sections of the American Academy of Pediatrics, has created referral recommendations intended to serve as voluntary practice parameters to assist general pediatricians in determining when and to whom to refer their patients for pediatric surgical specialty care. It is recognized that these recommendations may be difficult to implement, because communities vary in terms of access to major pediatric medical centers. Limited access does not negate the value of the recommendations, however, because the child who needs specialized surgical and anesthetic care is best served by the skills of the appropriate pediatric surgical team.

Towards an autonomous robot for camera control during laparoscopic surgery.

Introduction: During laparoscopic surgery, the surgeon currently must instruct a human camera operator or a robotic arm to move the camera. This process is distracting, and the camera is not always placed in an ideal location. To mitigate these problems, we have developed a test platform that tracks laparoscopic instruments and automatically moves a camera with no explicit human direction.

The pediatric surgeon and the American Academy of Pediatrics (AAP): an important partnership for surgeons and children.

The American Academy of Pediatrics provided a home for pediatric surgery when organized surgery did not recognize the specialty. They have continued to support surgical specialties in their pursuit of quality in education, training and practice. The AAP has appropriate infrastructure to support advocacy at both the federal and state levels.

Identification of pediatric brain neoplasms using Raman spectroscopy.

Purpose: Raman spectroscopy can quickly and accurately diagnose tissue in near real-time. This study evaluated the capacity of Raman spectroscopy to diagnose pediatric brain tumors.

Experimental Design: Samples of untreated pediatric medulloblastoma (4 samples and 4 patients), glioma (i.

Conclusions and data analysis: a 6-year study of Raman spectroscopy of solid tumors at a major pediatric institute.

Purpose: Create a Raman spectroscopic database with potential to diagnose cancer and investigate two different diagnostic methodologies. Raman spectroscopy measures the energy of photons scattered inelastically by molecules. These molecular signatures form the basis of identifying complex biomolecules and can be used to differentiate normal from neoplastic tissue.

The right ventricular systolic to diastolic duration ratio: a simple prognostic marker in congenital diaphragmatic hernia?

Aims: (i) To compare the ratio of right ventricular systolic to diastolic duration (SD/DD) in infants with congenital diaphragmatic hernia (CDH) and normal controls and (ii) to examine its association, if any, with outcomes in CDH.

Methods:   Retrospective chart and echocardiographic review of consecutive neonates (<1 month old) with CDH and term controls without structural heart defects. Right ventricular SD/DD was calculated by a single reader.

Clinical risk factors for gastroschisis and omphalocele in humans: a review of the literature.

Gastroschisis and omphalocele are usually considered together since they are both congenital abdominal wall defects, and yet their anatomy, embryogenesis, and clinical presentation and problems are quite different. In addition, it appears that the risk factors for their occurrence differ. Etiologic factors contributing to the development of these defects are unknown.

Differentiation of small round blue cell tumors using Raman spectroscopy.

Purpose: Small round blue cell tumors (SRBCTs) are aggressive undifferentiated embryonal tumors, including neuroblastoma, rhabdomyosarcoma, Ewing sarcoma, and non-Hodgkin lymphoma. They share similar histologic features. Additional studies such as immunohistochemistry and molecular techniques are required to differentiate them.