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Standardizing assessment of open vascular skills: National roll-out and early impact of the fundamentals of vascular surgery curriculum
No full textBackground: Exposure to open vascular case is declining in surgical training, creating a need for standardized, objective assessment of fundamental open skills. The Association of Program Directors in Vascular Surgery developed the Fundamentals of Vascular Surgery (FVS) curriculum to teach and assess three core skills—end-to-side anastomosis, patch angioplasty, and clockface precision suturing. This study describes FVS development and validation, nationwide rollout, and early implementation experience across U.S. training programs. Methods: A multiphase project was conducted: (1) validation (2012–2019) of the 3 FVS tasks with 313 trainees scored by trained raters using OSATS checklists and global rating scales; reliability and construct validity were assessed, including blinded secondary evaluations; (2) national rollout in 2024 with the distribution of FVS kits and online resources to integrated vascular residency programs; and (3) a 2025 Association of Program Directors in Vascular Surgery survey of program directors to characterize uptake, use patterns, perceived value, and barriers to implementation. Results: Performance on FVS tasks correlated strongly with training level (combined score r ≈ 0.93), with high inter-rater reliability (Cronbach\u27s α ≈ 0.93) and internal consistency (α ≈ 0.89). Each model discriminated junior from senior trainees. A finished-product-only review correlated less accurately with experience, supporting direct observation by trained evaluators. In the program director survey (35/78 responses), 42% had integrated FVS into their curriculum. Implementing programs reported improved assessment fidelity, effective remediation, and strong trainee engagement; all found it meaningful and all but one valued it for assessment. The most commonly cited barriers among nonimplementers were limited time and faculty bandwidth; successful sites commonly had dedicated faculty leadership and protected simulation time. Conclusions: FVS is a feasible and low-cost simulation curriculum that standardizes the assessment of essential open vascular skills. Early national experience shows a meaningful educational impact where implemented, but broader adoption will require protected time and faculty engagement. Future priorities include optimizing delivery (including remote/video-based assessment), supporting faculty development, expanding use beyond vascular surgery, and linking FVS performance to clinical outcomes
Survival Impact and Sociodemographic Correlates of Colon Cancer Surgery, Refusal
No full textBackground/Aim: Surgical treatment for colon cancer is often curative when diagnosed early. This study evaluated the sociodemographic characteristics and survival outcomes associated with refusal of surgery among patients with colon cancer. The objective was to identify disparities to improve patient outcomes. Patients and Methods: We conducted a retrospective cohort study using National Cancer Data Base (NCDB) data from 2004 to 2019, including 1,048,575 patients with colon cancer. Variables analyzed included demographics, tumor characteristics, treatment facility type, and geographic and socioeconomic factors. Descriptive statistics were assessed using Wilcoxon Rank Sum and Chi-square tests. Survival outcomes were evaluated using Kaplan–Meier analysis and multivariable Cox proportional hazards regression. Results: Among 1,048,575 patients with colon cancer, 87.6% underwent surgery, 11.5% did not due to treatment plan decisions, comorbidities, or unknown reasons, and 1.0% refused surgery. The mean age of those who refused surgery was 80.8 years, compared to 68.1 years overall. Surgery refusal was more common among females (61.4%), Black patients (16.6%), individuals with non-private insurance (87.3%), and those from metropolitan areas (77.4%). Survival outcomes significantly differed by surgical status (p \u3c 0.001). Patients who underwent surgery had the highest five-year survival (66%) and median survival (82.3 months), while those who refused surgery had a five-year survival of 55% and median survival of 66.1 months. Conclusion: Sociodemographic factors such as older age, Black race, female sex, lower income, non-private insurance, and non-Hispanic ethnicity were associated with higher refusal rates. Patients who refused surgery had lower five-year survival (55%) compared to those who underwent surgery (66%), underscoring the survival benefit of surgical intervention. These findings highlight the need for targeted efforts to reduce treatment disparities and improve education on treatment outcomes
Who Accesses Our Knowledge?
No full textIn pursuit of Open Access, it\u27s important to remember the accessibility needs of all user groups. This information session will examine the difference between website and electronic document accessibility standards, when it\u27s your responsibility to meet these standards, and simple steps and tools to maximize the reach of your scholarly outputs
Effects of Tai Chi on Psychological, Physiological, and Functional Outcomes in Lung Cancer: A Systematic Review of Randomized Controlled Trials
No full textMulti-omics Data Integration for the Discovery of Clinically Actionable Immune Modulated Biomarkers and Therapeutic Targets in Liver Cancer
No full textGene Therapy targeting Müller glial cells to treat Visual Loss in Usher Syndrome Type 1C (USH1C)
No full textMachine Learning Analysis of Gut Microbiome–Metabolome Links Alcohol & HIV-Associated Dysbiosis to Immune Senescence
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Diurnal behavioral outcomes and BBB integrity in adult male SHR and WKY rats
No full textDay and night neurobehavioral tests were performed for Spontaneously Hypertensive rats (SHR) and Wistar Kyoto rats (WKY) to establish an optimal testing window. Also, blood–brain barrier (BBB) integrity in brain areas related to cognition was measured to determine strain-specific differences. Six months old male SHR and WKY were randomly divided into day (i.e., 9–11 a.m.) and nighttime (i.e., 7–9 p.m.) testing regimen. Neurobehavioral tests included: Y-maze spontaneous alternation, open field, novel object recognition (NOR), and tail suspension test (TST). BBB integrity was measured in the cortex, hippocampus and striatum. WKY showed higher recognition memory at night compared to SHR and daytime test groups. Working memory and exploratory behavior were higher for SHR at both testing times when compared to WKY. During the day and when compared to WKY, SHR showed significant depression-like behavior which was absent during the night. SHR exhibited a higher anxiety-like behavior at both testing times when compared to WKY. Immunofluorescent signal for FITC-Dextran significantly increased in brain regions of SHR compared to WKY, but BBB tight junction proteins decreased suggesting impaired BBB integrity in SHR. In sum, NOR and TST are best performed during the dark phase to observe actual baseline outcomes for SHR and WKY. Neurobehavioral outcome differences between strains are independent of BBB integrity