Arnold Schwarzenegger or Danny DeVito? The fate of twins with necrotizing enterocolitis in the NICU.

Introduction: Previous literature suggests infants of multiple gestation pregnancies have a higher incidence of necrotizing enterocolitis (NEC) than singleton gestations; however, no study has examined the likelihood of co-incident NEC among multiples. We hypothesized an increased incidence of NEC among multiples whose siblings were diagnosed with NEC.

Methods: The admissions of infants to neonatal intensive care units were abstracted from the Pediatric Health Information System between 2017 and 2023.

NAPRT expression and epigenetic regulation in pediatric rhabdomyosarcoma as a potential biomarker for NAMPT inhibition.

Purpose: New treatments are needed to improve survival in children with rhabdomyosarcoma (RMS). NAD⁺ biosynthesis, regulated by the enzymes NAPRT and NAMPT, represents a metabolic vulnerability due to high NAD⁺ turnover in cancers. Although NAMPT inhibitors (NAMPTi) show preclinical promise, clinical translation has been limited by toxicity and the lack of predictive biomarkers.

An Open-Source Normothermic Perfusion System Designed for Research Scientists.

The integration of ex vivo perfusion machines for human organs prior to transplantation has improved outcomes for recipients and increased organ availability while revealing novel avenues of investigation for translational medicine. However, these machines have limited availability for experimental modifications while presenting a significant upfront cost investment and prohibitive per-use cost to the research scientist. Furthermore, there is a significant need for improved pre-clinical models in biomedical research that allow for authentic interrogation of cellular processes in the multi-cellular organ setting.

Expression of IMPACT curtails metabolic plasticity and augments NK cell killing to abrogate metastatic growth.

Given the propensity of aggressive epithelial tumors to form hepatic metastases, we performed an in vivo cDNA screen using the mouse liver and KRASG12D/TP53R273H pancreatic cells to identify the RNA binding protein GCN1 as integral component of hepatic outgrowth. RNAi experiments reveal that GCN1 triggers the ISR to activate serine, folate, and methionine biosynthetic pathways together with amino acid transporters, which act in concert to facilitate acquisition of metabolites and to restore redox homeostasis. Alongside activation of the ISR, we found that GCN1 also functions in the nucleus where it interacts with HNRNPK to suppress the expression of MHC-I molecules, and natural killer (NK) ligands.

Prevalence of Critical Congenital Heart Defects Among Neonates Born With Abdominal Wall Defects.

Introduction: We hypothesized that there is a higher prevalence of critical congenital heart defects (CCHD) among infants born with gastroschisis, which leads to worse outcomes during index neonatal intensive care unit (NICU) admission.

Methods: Rates of gastroschisis, omphalocele, and CCHD were calculated from Department of Health and Human Services (HHS) annual data on all live births in the US. Separately, NICU admissions to the Pediatric Health Information System (PHIS) between 2017 and 2023 were analyzed for diagnosis of gastroschisis, omphalocele, or CCHD, as identified by ICD-10 codes.

Relationship Between Total Parenteral Nutrition, Ventilation, and Hepatoblastoma: A Study of 258,929 Neonatal Intensive Care Unit Admissions.

Introduction: Gestational age, low birth weight, and overgrowth syndromes are associated with the diagnosis of hepatoblastoma. Previous studies have come to mixed conclusions regarding the contribution of other neonatal intensive care unit (NICU) exposures to hepatoblastoma development. We hypothesized that total parenteral nutrition (TPN) and mechanical ventilation during index NICU admission would correlate with the development of hepatoblastoma.

The Impact of Medical School Experiences in Global Surgery on Perceptions and Career Plans Among U.S. Medical Students.

Introduction: There is a growing interest among medical students to learn about global surgery and how they can incorporate it into their further training in residency. This study addresses US-based medical student perceptions of global surgery, medical school experiences, and career plans.

Methods: A cross-sectional survey study of US-based medical students was performed.

Local Infrastructure and Economy Predicts Traffic Related Fatalities in Children.

Purpose: Previous research on pediatric motor vehicle collisions (MVC) and fatalities has primarily focused on patient demographics and crash specific information. This study evaluates whether various measures of local infrastructure, including the National Walk Index (NWI), population density, and public school density, or macroeconomic forces, encapsulated in Social Vulnerability Index (SVI) and food area deprivation (PFA) can predict which counties are most at risk for pediatric traffic fatalities.

Methods: Counties with more than 100,000 children in the most recent US census and ≥1 pediatric traffic fatality as identified in the Fatality Analysis Reporting System (FARS) between 2017 and 2021 were included in the study.

The Perceived Impact of Global Surgery Engagement on Career Advancement among US Medical Students.

Introduction: There is growing interest among medical institutions to formalize global surgery training. Understanding medical students' perceptions of how global surgery engagement can enhance career advancement is essential for providing appropriate guidance and support for individuals with aspirations in academic global surgery.

Methods: A cross-sectional survey study of US-based medical students from 38 participating schools was performed.

Unplanned Readmission Rate Before Interval Appendectomy After Nonoperative Management of Complicated Appendicitis.

Background: There remains clinical equipoise regarding the preference for upfront appendectomy or nonoperative management for patients with complicated appendicitis. However, the natural history of the appendix after nonoperative management and pending interval appendectomy in children is not well characterized, and the risk of recurrent appendicitis as a function of time from index admission not known.

Study Design: The Pediatric Health Information System was queried for all patients younger than 18 years with an ICD-10 diagnosis code for complicated appendicitis admitted between 2018 and 2021.

Outcomes Following Implementation of an Electronic Model for Perioperative Hematologic Consultation.

Introduction: Electronic consultations (e-consults) for periprocedural hematologic questions were introduced at the VA Connecticut Healthcare System in 2011. We sought to explore the relationship between the availability of e-consults, referral patterns, and surgical outcomes.

Methods: A single-center retrospective study of all perioperative hematologic consultations from 2006 to 2018 was conducted.

The contemporary management of peritoneal metastasis: A journey from the cold past of treatment futility to a warm present and a bright future.

Peritoneal metastasis (PM) is often regarded as a less frequent pattern of spread; however, collectively across all spectra of primary tumors, the consequences of PM impact a large population of patients annually. Unlike other modes of metastasis, symptoms at presentation or during the treatment course are common, representing an additional challenge in the management of PM. Early efforts with chemotherapy and incomplete surgical interventions transiently improved symptoms, but durable symptom control and survival extension were rare, which established a perspective of treatment futility for PM through most of the 20th century.

Optimizing surgical education through the implementation of a feedback curriculum.

Background: While the advent of work-hour restrictions contributes to increased resident well-being, new interventions are needed to ensure that surgical residents continue to be adequately trained. Our study aims to take the evidence supportive of enhanced feedback and apply it in the real world by creating a feedback training curriculum within a surgical residency.

Methods: A large academic general surgery residency program consisting of 42 residents was sequentially surveyed using the Kirkpatrick model to assess baseline attitudes towards feedback and the efficacy of a feedback training program for faculty and residents.

Assessing the immediate impact of COVID-19 on surgical oncology practice: Experience from an NCI-designated Comprehensive Cancer Center in the Northeastern United States.

Background: The effects of the coronavirus disease 2019 (COVID-19) pandemic on surgical oncology practice are not yet quantified. The aim of this study was to measure the immediate impact of COVID-19 on surgical oncology practice volume.

Methods: A retrospective study of patients treated at an NCI-Comprehensive Cancer Center was performed.

Use of the six core surgical indicators from the Lancet Commission on Global Surgery in Colombia: a situational analysis.

Background: Surgical, anaesthetic, and obstetric (SAO) health-care system strengthening is needed to address the emergency and essential surgical care that approximately 5 billion individuals lack globally. To our knowledge, a complete, non-modelled national situational analysis based on the Lancet Commission on Global Surgery surgical indicators has not been done. We aimed to undertake a complete situation analysis of SAO system preparedness, service delivery, and financial risk protection using the core surgical indicators proposed by the Commission in Colombia, an upper-middle-income country.