Academic Surgical Congress Research Articles

The association between frailty and outcomes following ruptured abdominal aortic aneurysm repair: Presented at the Eighteenth Annual Academic Surgical Congress, Houston, Texas, February 7-9, 2023.

The association between frailty and outcomes following ruptured abdominal aortic aneurysm repair: Presented at the Eighteenth Annual Academic Surgical Congress, Houston, Texas, February 7-9, 2023.

View From the Chair: The First 5 years.

Department of Surgery, Boston University Medical Center, Boston, MA No external sources of support or funding contributed to this work. View from the Chair Note from the authors: This article was built on the scaffolding of a talk given by one of the authors (JT) at the Academic Surgical Congress during a Society of University Surgeons Hot Topics Session in February 2022 in Orlando, Florida. The authors report no conflicts of interest. [email protected]

The 2020 Pandemics: Lessons Learned in Academic Surgery and Beyond.

2020 was a significant year because of the occurrence of two simultaneous public health crises: the coronavirus pandemic and the public health crisis of racism brought into the spotlight by the murder of George Floyd. The coronavirus pandemic has affected all aspects of health care, particularly the delivery of surgical care, surgical education, and academic productivity. The concomitant public health crisis of racism and health inequality during the viral pandemic highlighted opportunities for action to address gaps in surgical care and the delivery of public health services. At the 2021 Academic Surgical Congress Hot Topics session on flexibility and leadership, we also explored how our military surgeon colleagues can provide guidance in leadership during times of crisis. The following is a summary of the issues discussed during the session and reflections on the important lessons learned in academic surgery over the past year.

The Baby and the Board: A Step Toward Normalizing Childbearing During Surgical Training.

The Baby and the Board: A Step Toward Normalizing Childbearing During Surgical Training.

From Presentation to Publication: Where did Abstracts at the 2017 Academic Surgical Congress End up? A Three-Year Analysis

Medical school and residency programs encourage increased research, and thousands of abstracts are submitted to conferences annually. This study sought to determine the rate of publication of oral presentations from the 2017 Academic Surgical Congress (ASC) and assess factors that influence the likelihood of publication. Abstracts selected for oral, plenary, and QuickShot presentations at the 2017 ASC were evaluated for publication status. Publication status, including date of publication and journal title, the academic rank of first and senior authors, and the type of study were collected. Senior author funding status, as well as source and amount of funding, were cataloged. These variables were noted at 16mo and then later at 34mo after the conference. Of the 360 oral and plenary presentations, 41.4% (n=149) and 70.5% were published at 16 and then 34mo, respectively. At 16mo, Basic science, Clinical outcomes, and Education had publication rates of 31.7%, 51.1%, and 57.7%. At 34mo, they were 76.1%, 69.1%, and 60.06%. QuickShot presentations had a publication rate of 17%, 69%, and 14% for Basic Science, Clinical Outcomes, and Education, respectively. At 16mo, abstracts with senior authors with an academic rank of Assistant Professor, Associate Professor, and Professor had publication rates of 43.3% (22), 49.4% (39), and 41.8% (37), respectively (P=0.697). At 34mo, publication rates for senior authors was 21.8% (53), 32.9% (80), and 45.2% (110) for Assistant Professor, Associate Professor, and Professor, respectively (P=<0.01). Quick shot presentations had publication rates of 14%, 26%, and 49% for Assistant Professor, Associate Professor, and Professor, respectively. 191 (53.2%) senior authors had funding, of which 125 (66.8%) were from the National Institute of Health. 61% of abstracts with a funded senior author went on to be published, whereas 38.9% of abstracts with an unfunded senior author were published. The presence of funding continued to have a positive association with publication (P<0.01 versus P<0.01) at 16 and 34mo postconference. In QuickShot presentations, 88% of abstracts with a funded senior author went on to be published. Of Quick shot presentations without funding, 100% were published. There was an increase in publication rate from 16 to 34mo after the 2017 ASC conference for oral presentations. At longer follow-up, the academic rank of the senior author and the funded abstracts were associated with abstracts achieving publication, whereas the academic rank of the first author, presentation type, and funding source was not. Funding was significantly associated with the Presentation Type at the conference and the Journal Impact Factor of the manuscript, whereas abstract type was not. QuickShot presentations did not fare as well regarding publication status; at approximately 3y, the publication rate was 43%.

Surgeons and social media: The use of twitter hashtags at the Academic Surgical Congress 2015–2019: A cross sectional study

BackgroundThe use of Twitter hashtags at medical conferences has revolutionized the way healthcare professionals interact and advance their education. We aim to investigate the scope of the Academic Surgical Congress's online reach and engagement through the use of Twitter hashtags #ASC from 2015 to 2019, by analyzing the number of impressions and tweets and retweets. MethodsA cross sectional study of Twitter data through Symplur with the following conference hashtags for the Academic Surgical Congress annual meetings for years 2015–2019: #ASC2015, #ASC2016, #ASC2017, #ASC2018, and #ASC2019. Data on tweets, retweets, users, and impressions was reviewed along with information on the top 10 influencers and the most frequently tweeted links. Symplur Signals software was utilized to extract and assimilate data. Statistical Significance was defined as p < 0.05. ResultsTwitter engagement metrics significantly increased from 11,400 to 32,100 from 2015 to 2017 (p < 0.05). However, from 2017 to 2019, there was a significant decline in engagement metrics from 32,100 to 26,100 (p < 0.05). Impressions increased significantly from 13,100 in 2015 to 71,800 impressions in 2019 (p < 0.05). Users grew significantly from 1500 in 2015 to peak at 4600 in 2017 before dropping back to 3300 in 2019 (p < 0.05). The most influential organizations during these years were the organizers of the conference: Association for Academic Surgery and the Society of University Surgeons. Conference attendance progressively increased from approximately 1700 in 2016 to about 2100 in 2019 (p < 0.05). ConclusionsTwitter engagement metrics at the Academic Surgical Congress 2015–2019 has fluctuated, while impressions significantly increased through the years indicating the consistent dissemination of conference content.

Closing the Gender Gap in Global Surgery: Trends at the Academic Surgical Congress

IntroductionFemale researchers are underrepresented in academic surgery. While they are increasingly producing original research, they lag male researchers in productivity. This disparity is not well understood within the nascent field of global surgery. The following study examines gender parity in global surgery research presented at the Academic Surgical Congress and within subsequent publications. MethodsAbstracts presented at the Academic Surgical Congress (ASC) between 2015 and 2019 in “Global Surgery” sessions were reviewed to obtain title, the first author (FA) and senior author (SA). The authors were classified by gender. The Scopus database was queried by two reviewers for abstracts with corresponding publications, citations, and journal impact factors. Statistical analysis was conducted using chi-square analysis and t-tests where appropriate. ResultsOf a total of 6635 abstracts, 218 global surgery abstracts over a 5-year period were identified. Of these abstracts, 96 (44%) had female FAs, while 56 (26%) had female SAs. When comparing gender, female (44%) FAs and male (56%) FAs were equally represented. While SAs were significantly less likely to be female (26% versus 74%, P < 0.0001), female senior authorship increased significantly within the study period. Output with respect to publications, citations, and journal impact factors were equal by gender. ConclusionsThis study presents 5 y of gender trends in global surgery scholarly work presented at the ASC. Despite an overall predominance of male senior authors, the paradigm is shifting with a recent trend to gender parity. Male and female authors have equal output and are equally impactful. Findings of gender equity in academic global surgery are encouraging, and further study of other disciplines are warranted.

Trends in Gender Representation at the American College of Surgeons Clinical Congress and the Academic Surgical Congress: A Mixed Picture of Progress

There has been increasing attention to gender inequity in speakers at professional meetings. The aim of this study was to evaluate temporal trends in representation of women at the Academic Surgical Congress (ASC) and American College of Surgeons Clinical Congress (CC), 2 prominent general interest, national surgical meetings. We reviewed ASC (2014-2019) and CC (2013-2018) meeting programs to determine counts and proportions of invited panelists and moderators by gender, including the frequency of men-only panels. We conducted trend analyses to assess for temporal change in gender representation and univariate tests of association between different measures of gender representation. The overall proportions of women panelists were 35% (ASC) and 28% (CC). There was a significant increase in the proportion of women panelists over the study period at the CC (23% to 34%, p= 0.007) but not at the ASC (37% to 36%, p= 0.79). The proportion of men-only panels decreased significantly over time at the CC (38% to 23%, p= 0.04), but not at the ASC (23% to 17%, p= 0.50), while the proportion of moderators at the ASC increased significantly (31% to 43%, p= 0.01), but not at the CC (29% to 37%, p= 0.40). Women remain in the minority of panelists and moderators at the ASC and CC meetings, and approximately 1 in 5 panels are composed entirely of men. Although progress has been made at both meetings, ongoing and deliberate attention is needed to ensure continued progress toward the goal of equitable gender representation in academic surgery.

Pathway Analysis of Gene Expression in Murine Fetal and Adult Wounds.

Objective: In early gestation, fetal wounds heal without fibrosis in a process resembling regeneration. Elucidating this remarkable mechanism can result in tremendous benefits to prevent scarring. Fetal mouse cutaneous wounds before embryonic day (E)18 heal without scar. Herein, we analyze expression profiles of fetal and postnatal wounds utilizing updated gene annotations and pathway analysis to further delineate between repair and regeneration. Approach: Dorsal wounds from time-dated pregnant BALB/c mouse fetuses and adult mice at various time points were collected. Total RNA was isolated and microarray analysis was performed using chips with 42,000 genes. Significance analysis of microarrays was utilized to select genes with >2-fold expression differences with a false discovery rate of <2. Enrichment analysis was performed on significant genes to identify differentially expressed pathways. Results: Our analysis identified 471 differentially expressed genes in fetal versus adult wounds following injury. Utilizing enrichment analysis of significant genes, we identified the top 20 signaling pathways that were upregulated and downregulated at 1 and 12 h after injury. At 24 h after injury, we discovered 18 signaling pathways upregulated in adult wounds and 11 pathways upregulated in fetal wounds. Innovation: These novel target genes and pathways may reveal repair mechanisms of the early fetus that promote regeneration over fibrosis. Conclusion: Our microarray analysis recognizes hundreds of possible genes as candidates for regulators of scarless versus scarring wound repair. Enrichment analysis reveals 109 signaling pathways related to fetal scarless wound healing.

Overcoming adversity—a critical step toward career satisfaction and leadership in academic surgery

The experiences of life are what shape us. This article relays stories of adversity and resiliency as experienced and told by members of our own surgical community at the Academic Surgical Congress in Las Vegas, NV in February 2017. We aim to express in words the lessons of each experience so that others can learn about life and leadership.

SMO Inhibition Modulates Cellular Plasticity and Invasiveness in Colorectal Cancer.

HIGHLIGHTS Preliminary results of this work were presented at the 2016 Academic Surgical Congress, Jacksonville (FL), February 2–4 2016 (Original title: Selective Smo-Inhibition Interferes With Cellular Energetic Metabolism In Colorectal Cancer)This study was funded by “Sapienza—University of Rome” (Funds for young researchers) and “AIRC” (Italian Association for Cancer Research)Hedgehog inhibitor was kindly provided by Genentech, Inc.®.Colon Cancer (CC) is the fourth most frequently diagnosed tumor and the second leading cause of death in the USA. Abnormalities of Hedgehog pathway have been demonstrated in several types of human cancers, however the role of Hedgehog (Hh) in CC remain controversial. In this study, we analyzed the association between increased mRNA expression of GLI1 and GLI2, two Hh target genes, and CC survival and recurrence by gene expression microarray from a cohort of 382 CC patients. We found that patients with increased expression of GLI1 showed a statistically significant reduction in survival. In order to demonstrate a causal role of Hh pathway activation in the pathogenesis of CC, we treated HCT 116, SW480 and SW620 CC cells lines with GDC-0449, a pharmacological inhibitor of Smoothened (SMO). Treatment with GDC-0449 markedly reduced expression of Hh target genes GLI1, PTCH1, HIP1, MUC5AC, thus indicating that this pathway is constitutively active in CC cell lines. Moreover, GDC-0449 partially reduced cell proliferation, which was associated with upregulation of p21 and downregulation of CycD1. Finally, treatment with the same drug reduced migration and three-dimensional invasion, which were associated with downregulation of Snail1, the EMT master gene, and with induction of the epithelial markers Cytokeratin-18 and E-cadherin. These results were confirmed by SMO genetic silencing. Notably, treatment with 5E1, a Sonic Hedgehog-specific mAb, markedly reduced the expression of Hedgehog target genes, as well as inhibited cell proliferation and mediated reversion toward an epithelial phenotype. This suggests the existence of a Hedgehog autocrine signaling loop affecting cell plasticity and fostering cell proliferation and migration/invasion in CC cell lines. These discoveries encourage future investigations to better characterize the role of Hedgehog in cellular plasticity and invasion during the different steps of CC pathogenesis.

2014 Society of University Surgeons Presidential Address

Good morning, and welcome to the 9th annual Academic Surgical Congress, and the 75th meeting of the Society of University Surgeons (SUS). During the past year, I began considering the role of the Society of University Surgeons in our matrix as university surgeons and our joint meeting with the Association for Academic Surgery (AAS). How could the Academic Surgical Congress (ASC) have grown so rapidly during a short period of time? What value do the SUS, the AAS, and the ASC bring to each of you sitting in the audience today? As you sit here in this auditorium, on occasion checking in with the rest of your life on your smart phone, you may be asking the question “why am I here?” Why have I traveled hundreds of miles, put my schedule on pause, arranged for coverage of my patients, traveled away from my family and friends, and generally put my life on hold to attend this meeting?

Use of Twitter to document the 2013 Academic Surgical Congress

BackgroundSocial media is a cornerstone of modern society and its use in health care has rapidly expanded in recent years. “Live Tweeting” of professional meetings is a growing way for participants to communicate with peers. The goal of this study was to analyze the initial experience with implementation of a Twitter Team at the 2013 Academic Surgical Congress (ASC). Materials and methodsFour ASC attendees were designated as the “Twitter Team” for the 2013 meeting. Organizational leadership prominently promoted the unique meeting hashtag (#2013ASC). Twdocs and TweetReach were used to aggregate data 1 wk after the meeting. ResultsA total of 58 independent users posted tweets with the #2013ASC hashtag during the week of the meeting. Total tweets numbered 434, with 288 original tweets. Of the 37 users who were identifiable individuals, 19 were in attendance at the ASC; 18 of the identifiable individuals were members of either the Association for Academic Surgery and/or the Society of University Surgeons. The ASC Twitter Team was responsible for 76% of all #2013ASC tweets. The three most common content areas for tweets were promotional (147), content related from presidential sessions (96), and social (75). ConclusionsTwitter provides a meaningful social media format for sharing information during academic surgical meetings. The use of Twitter sharply expands the available audience for meeting proceedings and broadens the discussion venue for scholarly activity. “Tweeting the meeting” represents an important future direction for information dissemination in academic surgery.

Use of Twitter to Document the Academic Surgical Congress: A Pilot Experience

Social media is a cornerstone of modern society and its use in healthcare has rapidly expanded in recent years. “Live Tweeting” of professional meetings is increasingly used by participants to communicate with peers. The goal of this study was to analyze the initial experience with implementation of a Twitter Team at the 2013 Academic Surgical Congress (ASC).

The Art and Science of Publishing: Reflections from Editors of Surgery Journals.

During the 8th Annual Academic Surgical Congress held in New Orleans, Louisiana, on February 5–7, 2013, the Association for Academic Surgery (AAS) Presidential Session was dedicated to the topic of publishing. A survey consisting of 37 questions on issues related to publishing was administered to the AAS membership 1 mo before the meeting. The results of the survey were then presented during the 2013 AAS Presidential Session. In addition, a panel of five editors from surgery journals relevant to the membership of the AAS was convened to discuss topics addressed in the results of the survey. These topics included: (1) how to publish in high-impact factor journals; (2) top five reasons why manuscripts get rejected; (3) the do's and don'ts of publishing (i.e., ethics of publishing); (4) how to get on an editorial board; and (5) the future of publishing. This review summarizes the contents of this AAS Presidential Session and provides information relevant for any academician, investigator, or scientist.

Editorial introductions

Current Opinion in Organ Transplantation was launched in 1996. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of organ transplantation is divided into 18 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Ernest van HeurnErnest van HeurnErnest van Heurn is a transplant surgeon and Professor at the Maastricht University Medical Centre in the Netherlands. He qualified as Medical Doctor at Leiden University, the Netherlands, in 1988 and was a fellow at the cardiothoracic transplant department of Papworth Hospital, Cambridge, UK (Sir Terence English) afterwards. He received his formal specialist training in general surgery and later in transplant surgery from Professor Gauke Kootstra at the Maastricht University Medical Centre, where he also obtained his PhD degree in 1997. Dr van Heurn succeeded his former chief as head of the surgical transplantation department and the organ preservation laboratory in 2002. Next to his clinical work as transplant surgeon, he is trainer-surgeon of the national abdominal organ procurement teams and responsible for regional organ donation and procurement in the Maastricht area. His research interests include kidney transplantation from donors after cardiac death, organ preservation and renal ischaemia reperfusion injury. His research group focuses on transplantation of marginal kidneys, particularly of ischaemically damaged kidneys from donors after cardiac death. The emphasis is on kidney preservation techniques, viability testing and strategies to improve kidney function before or immediately after transplantation, which are studied both clinically and in animal models. Ernest van Heurn is member of the Editorial Board of several international journals and is presently one of the chairs of the European expert panel to provide recommendations for transplantation of kidneys from donors after cardiac death. Jeffrey L. PlattJeffrey L. PlattJeffrey L. Platt, M.D. is Professor of Surgery and of Microbiology at the University of Michigan, USA. He co-directs the Transplantation Biology Program. Dr Platt graduated from the University of Southern California School of Medicine, USA and trained in pediatrics (Childrens Hospital of Los Angeles, USA) and nephrology (University of Minnesota, USA). Dr Platt's research addresses such questions as how T cells and B cells and their products interact with tissues to cause disease, how these interactions induce protection against further injury (accommodation), how novel technologies can be directed at replacing organ function and restoring immunological fitness and how fusion of one cell with another impacts on genomic integrity and cellular function. Dr Platt has published 550 papers and 4 books. He is a long standing member of the American Society of Nephrology, the American Heart Association, the FASEB (Immunology and Experimental Pathology), the Association of American Physicians and the Institute of Medicine of the National Academy of Sciences (USA). Anton I. SkaroAnton I. SkaroAfter completing a multi-organ transplant surgery fellowship at Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA, Dr Skaro was appointed as an Assistant Professor in the Department of Surgery. He performs adult and pediatric abdominal solid organ transplants at Northwestern Memorial Hospital and Lurie Children's Hospital of Chicago, USA. Dr Skaro's clinical and academic interests have evolved and are now focused on risk stratification and the econometrics of liver, and kidney transplantation with an emphasis on utilization of organs donated after cardiac death and risk aversion in transplantation. As his interests shifted toward risk stratification in transplantation, he was appointed as the Director of Quality Assessment and Performance Improvement and Associate Director of Kidney and Pancreas Transplantation at the Comprehensive Transplant Center of Northwestern University. The advances in risk assessment particularly relating to donation after cardiac death (DCD) liver transplantation have been recognized nationally. Dr Skaro has been acknowledged as an expert in the field of Donation after Cardiac Death, having been invited to present at the American Transplant Congress, Academic Surgical Congress, and American Association for the Study of Liver Diseases Meeting. Furthermore, he has published several reports examining the economic and clinical outcomes of DCD liver transplant which appear in Surgery, Liver Transplantation, Annals of Surgery and the Journal of Hepatology. Dr Skaro has more recently focused on investigating the unintended consequences of regulatory oversight including risk averse transplant center behavior. Dr Skaro is an active member in multiple nationally based committee efforts sanctioned by the American Society of Transplant Surgeons, the United Network for Organ Sharing, and the Health Resources and Services Administration including the Standards Committee, Reimbursement Committee, Operations and Patient Safety Committee, and Donor Management Taskforce.

Critical Skills for the Senior Medical Student Entering Surgery

Abstract Introduction Critical response skills focusing on the management of acute, life-threatening emergencies in postoperative patients are important topics that are not uniformly covered in med...

Ward Management Basics for the Senior Medical Student Entering Surgery: Part B

Abstract Introduction Significant attention has been directed toward developing preparatory courses to heighten the readiness of senior medical students as they transition to surgical residency. To...

Scientific impact of Association for Academic Surgery and Society of University Surgeons plenary session abstracts increases in the era of the Academic Surgical Congress from 2006 to 2010

BackgroundThe objective of our study was to analyze plenary abstracts since 2006, when the Association for Academic Surgery (AAS) and Society of University Surgeons (SUS) began hosting the combined annual Academic Surgical Congress (ASC). Plenary session abstracts from the separate AAS and SUS meetings from 2002 to 2004 had previously revealed no significant difference in the scientific impact of published manuscripts. Materials and methodsIn total, 76 abstracts from the AAS (n = 40) and SUS (n = 36) plenary sessions at the annual ASC meetings (2006–2010) were reviewed. Publication rate, citation number, 2010 impact factor (IF), and 5-y IF were obtained. Statistical analysis was conducted using Fisher exact and Student t-tests. ResultsOverall, 60 (79%) of 76 ASC plenary abstracts presented between 2006 and 2010 were published in peer-reviewed journals. Analysis revealed a higher publication rate for AAS (90%) compared with SUS (67%) plenary abstracts (P = 0.02). Among the articles published, the overall mean number of total citations was 6.7, with no difference between AAS and SUS (5.9 versus 7.8, P = 0.46). The mean 2010 five-year IF for all publications was 4.6 (AAS, 4.3 versus SUS, 5.0; P = 0.54). Compared with a previous analysis from the separate meetings, the mean IF has increased for both societies at an equivalent rate of 0.4. ConclusionsAfter the initiation of the joint ASC meeting in 2006, the SUS and AAS plenary presentations continue to exhibit high-quality research. This study supports the benefit of a joint meeting for the AAS and SUS, as it has been associated with an increasing overall scientific impact for plenary abstracts.

Scientific Impact of AAS/SUS Plenary Session Abstracts Increases in the Era of the Joint Academic Surgical Congress, 2006-2010

Scientific Impact of AAS/SUS Plenary Session Abstracts Increases in the Era of the Joint Academic Surgical Congress, 2006-2010