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Airway management is an essential element of surgical training, but with fewer procedures performed during residency, simulation is crucial to fill educational gaps. We evaluated the effect of a multidisciplinary airway simulation on the comfort of general surgery residents in managing airways. All residents PGY 2-5 at a large academic general surgery residency program participated in a multidisciplinary airway management simulation. Precourse surveys evaluated self-perception of skills in three areas of airway management: surgical airway, basic ventilator strategies, and endotracheal intubation. Simulation consisted of didactic and procedural components and used high- and low-fidelity models including silicon airways, ventilators, porcine trachea, and airway adjuncts. Instruction was provided by anesthesia and otolaryngology faculty. Postcourse assessment was performed with a four-level Likert questionnaire. Results were analyzed using paired t -tests. Of the 19 residents surveyed, 37% of residents had 1-5 h and 32% had 5-10 h of prior airway instruction. Significant increases in mean comfort were observed across all three studied areas. Residents reported increased comfort performing a surgical airway (1.16 versus 1.95), P < 0.0001, and troubleshooting ventilator issues (1.59 versus 2.16), P < 0.0001. Comfort regarding overall airway management including endotracheal intubation demonstrated similar improvement (1.84 versus 2.32), P = 0.02. Subgroup analysis by PGY level showed the greatest impact on comfort level in junior residents. Multidisciplinary airway simulation can be effectively implemented in a general surgery training program and positively affect trainee comfort with these techniques, particularly among junior residents. [ABSTRACT FROM AUTHOR]

Cervical spinal cord injury can be a particularly devastating sequela of trauma. The purpose of this study was to describe the imaging findings of adult patients with cervical spinal cord injury without computed tomography evidence of trauma (SCIWOCTET). All adult patients (≥18 years) treated for acute cervical SCIWOCTET at a single Level I adult trauma center over an eight-year period were retrospectively identified. CT imaging was evaluated for degenerative changes narrowing the midsagittal canal diameter (SCD) of the cervical spine and relative congenital cervical stenosis (CCS; congenital narrowing of the SCD <13 mm). Magnetic resonance imaging (MRI) scans were evaluated for signal intensity change (SIC) suspicious for cord edema/contusion as well as ligamentous injury, hemorrhage, and epidural hematoma. Ninety-six patients with cervical SCIWOCTET met inclusion criteria. The most common mechanism of injury was fall from standing (47.9%). On CT, 86 patients (89.6%) had CCS. Degenerative changes were present in 95 patients (99.0%). In 98/99 patients (99.0%), the point of narrowest cervical SCD was ≤8 mm. On MRI, 79 patients (82.3%) demonstrated signal intensity change (SIC) indicative of cord edema/contusion, while 16 (16.7%) had ligamentous injury. Intramedullary cord hemorrhage was seen in two patients (2.1%) and epidural hematoma in three (3.1%). Degenerative changes or CCS may narrow the minimum cervical SCD beyond the threshold at which low-energy trauma results in C-SCI. Adult patients with cervical spinal stenosis, whether congenital and/or degenerative, and neurologic findings referable to the cervical spine should be assessed for C-SCI. • Low energy trauma was often observed with the most common mechanism of injury being fall from standing height (47.9%). • Acute operative management in the form of cervical decompression occurred in 88 cases (91.7%). • On CT, 89.6% of patients demonstrated relative congenital cervical stenosis; degenerative changes were present in 99.0%. • In 98/99 patients (99.0%), the point of narrowest cervical SCD was ≤ 8 mm. • On MRI, 82.3% of patients demonstrated signal intensity change, while 16.7% had ligamentous injury that was not evident on CT. [ABSTRACT FROM AUTHOR]

Declines in bumblebee populations have led to investigations into potential causes – including agrochemical effects on bumblebee physiology. The indirect effects of agrochemicals (i.e. behavior modulation) have been postulated, but rarely directly tested. Olfactory information is critical in mediating bumblebee-floral interactions. As agrochemicals emit volatiles, they may indirectly modify foraging behavior. We tested the effects of olfactory contamination of floral odor by agrochemical scent on foraging activity of Bombus impatiens using two behavioral paradigms: localization of food within a maze and forced-choice preference. The presence of a fungicide decreased bumblebees’ ability to locate food within a maze. Additionally, bumblebees preferred to forage in non-contaminated feeding chambers when offered a choice between control and either fertilizer- or fungicide-scented chambers. [ABSTRACT FROM AUTHOR]