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The Burn Therapist Certification (BT-C) was introduced in 2018 to acknowledge occupational therapists (OT) and physical therapists (PT) with specialized knowledge, skill, and experience in the promotion of quality burn rehabilitation. Currently, BT-Cs make up 11.7% of therapists working in burn rehabilitation (n = 39/333). The purpose of this review is to report on the contributions of BT-Cs to organizational leadership of the American Burn Association (ABA) and in the generation of new knowledge through peer-reviewed publications. Despite the small percentage of burn therapists who are certified, they have a disproportionately large involvement in leadership within the ABA and burn research in the Journal of Burn Care and Rehabilitation (JBCR). From 2018 to 2023, BT-Cs have contributed to nearly one-half (n = 26/56) of therapy authored publications in the JBCR and almost one-third (n = 65/202) of accepted abstracts at the ABA annual meeting. Certified burn therapists demonstrate substantial involvement throughout the ABA, including maintaining an 85% membership rate and, on average, serve in 53% (n = 31/59) of the therapy allotted committee positions. Therapist pursuit of certification can have a profound impact on the burn community through publication, leadership, and development of care standards. Although therapists have indicated a desire to pursue certification, barriers related to a lack of association and center support have been identified. The burn community has endorsed certification as a mark of excellence for nurses and physicians. Maximizing the value of a transdisciplinary approach to burn care is also dependent on the excellence of therapies. If the burn community desires improved engagement and contribution from therapies, it should support therapist certification., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Cardiology providers and healthcare clinicians tackling heart failure (HF) face an escalating challenge: rising prevalence rates and widening disparities among populations. In this context, leveraging up-to-date and specialized data becomes paramount. Although the American Heart Association's (AHA) Heart and Stroke Statistics provides a sweeping overview of cardiovascular health with a few pages dedicated to HF and cardiomyopathy, the Heart Failure Society of America's (HFSA) HF Stats annual publication offers an up-to-date and in-depth look at multiple themes related to HF epidemiology, global trends, outcomes and much more. This article highlights the unique benefits of HF Stats, why providers and clinicians should want to utilize the report and its dedicated website, HFStats.org, and how the report contents can enhance clinical practice, research, and patient care., (Copyright © 2024. Published by Elsevier Inc.)

The 15th Annual Report from The Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support includes 29,634 continuous-flow left ventricular assist devices from the 10-year period between 2014 and 2024. The outcomes reported here demonstrate continued improved survival in the current era of fully magnetically levitated devices, with a significantly higher 1-year (85.7% vs 78.4%) and 5-year (59.7% vs 43.7%) survival than those receiving non-magnetically levitated devices. Magnetically levitated device recipients are experiencing a lower incidence of adverse events, including freedom from gastrointestinal bleeding (72.6%), device malfunction (82.9%), and stroke (86.7%) at 5 years. Additionally, a focus on a subgroup of patients younger than 50 years of age has demonstrated both superior outcomes in survival (91.6% survival at 1 year and 72.6% survival at 5 years) and decreased incidence of adverse events compared with older recipients. This younger cohort also demonstrated more tolerance to the characteristics of sex, race, ethnicity, and psychosocial indicators that are associated with worse outcomes after heart transplantation. Based upon these data, a potential net prolongation of life may be realized by considering prolonged left ventricular assist device support prior to heart transplantation in this population. These analyses provide preliminary data that could positively influence adoption of left ventricular assist device technology in groups previously not seen as candidates for this therapy, while providing a more responsible donor allocation strategy for advanced heart failure patients., Competing Interests: Disclosures Dan M. Meyer is on the clinical advisory board of PercAssist Corp. Aditi Nayak is on the clinical advisory board of PumpinHeart Limited, Ireland. Katherine L. Wood reports a relationship with Abbott that includes consulting or advisory. Sarah Schettle reports a relationship with the Medtronic Advisory Panel, and consulting with Abbott. James K. Kirklin discloses receiving partial salary support from the Society of Thoracic Surgeons (STS) as Director of the Data Center for STS Intermacs and being part owner and President of Kirklin Solutions, Inc., a University of Alabama at Birmingham (UAB) healthcare technology start-up company. Francis D. Pagani is a noncompensated ad-hoc scientific advisor for Abbott, Berlin Heals, FineHeart, and Medtronic, a non-compensated medical monitor for Abiomed, Scientific advisor for BrioHealth with travel compensation; and a member of the Data and Safety Monitoring Board (DSMB) for Carmat; and receives partial salary support from Blue Cross / Blue Shield of Michigan as Associate Director of the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative. Manreet K. Kanwar is on the Advisory Board for Abiomed, Abbott and CorWave, on CEC for BiVACOR, and a speaker for Abiomed. The other authors have no conflicts of interest to disclose., (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

The National Cancer Database (NCDB) collects data from approximately 1,500 Commission on Cancer (CoC) facilities and represent 73.7% of newly diagnosed cancers nationwide. The American College of Surgeons Cancer Program developed it first annual report from the NCDB 2021 participant user file reporting new observations and recent trends of cancer diagnoses, patient demographics, and treatments as well as an in-depth report on treatment and outcomes in breast, pancreas, and colon cancers. Of the 1,328,131 cancers diagnosed in 2021 at 1,281 reporting CoC hospitals, one-fifth continue to be female breast cancer. In 2021, the NCDB's 5 most common adult cancers were breast, prostate, lung, colon, and melanoma and varied by patient sex. Use of neoadjuvant systemic therapy increased in recent years in pancreas, breast, and urinary bladder cancer, although a slight decrease in pancreas and breast cancer was observed in 2021. Breast cancer has high survival rates, especially in lower-stage disease and estrogen receptor-positive/human epidermal growth factor receptor 2-negative disease. There is increase in neoadjuvant systemic therapy use, especially in human epidermal growth factor receptor 2-positive disease and estrogen receptor-negative disease. Colon cancer presents most commonly as stage III or II with a primary in the cecum or ascending colon in 38.9%. The majority are microsatellite instability stable, Kirsten rat sarcoma viral oncogene homologue normal, and CEA positive. Survival is most dependent on stage but also associated with microsatellite instability stability, abnormal Kirsten rat sarcoma viral oncogene homologue, and positive CEA. Pancreatic cancer presents with stage IV disease in nearly half, although an increase in stage I disease is seen. The most common location is pancreatic head. Survival is relatively low and most dependent on stage., (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Review the subsequent impact of recommendations made by the 2004 American Surgical Association Blue Ribbon Committee (BRC I) Report on Surgical Education., Background: Current leaders of the American College of Surgeons and the American Surgical Association convened an expert panel to review the impact of the BRC I report and make recommendations for future improvements in surgical education., Methods: BRC I members reviewed the 2004 recommendations in light of the current status of surgical education., Results: Some of the recommendations of BRC I have gained traction and have been implemented. There is a well-organized national curriculum and numerous educational offerings. There has been greater emphasis on preparing faculty to teach, and there are ample opportunities for professional advancement as an educator. The number of residents has grown, although not at a pace to meet the country's needs either by total number or geographic distribution. The number of women in the profession has increased. There is greater awareness and attention to resident (and faculty) well-being. The anticipated radical change in the educational scheme has not been adopted. Training in surgical research still depends on the resources and interests of individual programs. Financing student and graduate medical education remains a challenge., Conclusions: The medical landscape has changed considerably since BRC I published its findings in 2005. A contemporary assessment of surgical education and training is needed to meet the future needs of the profession and our patients., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Physician involvement in political advocacy has become increasingly important in recent years. This study aims to explore the types of involvement and barriers to involvement in political advocacy among American Shoulder and Elbow Surgeons (ASES) members, identify issues considered most important by ASES members, and assess demographic factors that might correlate with involvement in political advocacy efforts among ASES members., Methods: This survey was conducted by the ASES Political Advocacy Committee over a 2-week period in June 2021. The survey collected demographic information including sex, ethnicity, years in practice, practice type, political affiliation, and level of current involvement in political advocacy. Additional questions consisted of thoughts regarding current health care policy issues and the role of the American Academy of Orthopaedic Surgeons/ASES regarding such policy issues., Results: We received 297 responses for a total response rate of 27%. Of those who responded, 24.6% identified as Democrat, 33% identified as Republican, and 42.4% identified as Independent. There was no difference in political affiliation between membership groups. Physician Reimbursement (82%), Medical Liability Reform (50%), and Physician Ownership (50%) were the most important issues identified among respondents. Physician Ownership, Physician Reimbursement and Graduate Medical Education and Student Loan Reform were most important to those in early practice, while Quality and Research was most important to those with greater than 25 years of practice experience., Conclusion: There is strong agreement among surgeons regarding the most important political advocacy issues. The efforts of the American Academy of Orthopaedic Surgeons and ASES should focus on these areas. Additionally, the vast majority of respondents felt that advocacy efforts had a positive impact on patients and surgeons., (Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Objective: The American Medical Informatics Association (AMIA) Task Force on Diversity, Equity, and Inclusion (DEI) was established to address systemic racism and health disparities in biomedical and health informatics, aligning with AMIA's mission to transform healthcare. AMIA's DEI initiatives were spurred by member voices responding to police brutality and COVID-19's impact on Black/African American communities., Materials and Methods: The Task Force, consisting of 20 members across 3 groups aligned with AMIA's 2020-2025 Strategic Plan, met biweekly to develop DEI recommendations with the help of 16 additional volunteers. These recommendations were reviewed, prioritized, and presented to the AMIA Board of Directors for approval., Results: In 9 months, the Task Force (1) created a logic model to support workforce diversity and raise AMIA's DEI awareness, (2) conducted an environmental scan of other associations' DEI activities, (3) developed a DEI framework for AMIA meetings, (4) gathered member feedback, (5) cultivated DEI educational resources, (6) created a Board nominations and diversity session, (7) reviewed the Board's Strategic Planning for DEI alignment, (8) led a program to increase diversity at the 2020 AMIA Virtual Annual Symposium, and (9) standardized socially-assigned race and ethnicity data collection., Discussion: The Task Force proposed actionable recommendations that focused on AMIA's role in addressing systemic racism and health equity, helping the organization understand its member diversity., Conclusion: This work supported marginalized groups, broadened the research agenda, and positioned AMIA as a DEI leader while reinforcing the need for ongoing transformation within informatics., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Medical Informatics Association.)

This summary of the proceedings of the 2023 ACR Intersociety Meeting discusses the seven most important challenges facing radiology today: declining reimbursement, corporatization and consolidation, inadequate labor force, imaging appropriateness, burnout, turf wars with nonphysicians, and workflow efficiency. Participants in the Intersociety Summer Conference-2023 focused their effort on identifying potential solutions given how critical these topics are to the sustainability of the profession., (Copyright © 2024 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

Background: The Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD) was expanded in 2017 to include more granular detail on thoracic aortic surgeries. We describe the first validated risk model in thoracic aortic surgery from the STS ACSD., Methods: The study population consisted of patients undergoing nonemergent isolated ascending aortic aneurysm repair by open or clamped distal anastomoses, including those requiring aortic root or valve replacement. Model outcomes included operative mortality, 30-day major morbidity (cardiac reoperation, deep sternal wound infection, stroke, prolonged ventilation, renal failure), and a composite of both. To select the predictors, univariate associations and clinical face validity of models were examined. Models were evaluated by their ability to distinguish between patients with and without specific outcomes (discrimination) and their predictive accuracy (calibration)., Results: Between 2017 and 2021, 24,051 eligible patients underwent ascending aortic aneurysm surgery at 905 hospitals. Procedures included 8913 aortic root replacements, 2135 valve-sparing root replacements, 7545 ascending aortic replacements with aortic valve replacement, and 5458 ascending aortic replacements. Circulatory arrest was performed in 7316 (30.4%) cases. Operative mortality was 1.9%, and 12.2% of patients experienced major morbidity including 2.4% incidence of stroke. The adjusted C statistics for the model were 0.74, 0.67, and 0.67 for mortality, morbidity, and the composite, respectively. Previous stroke and circulatory arrest were associated with new stroke. Genetic aortopathy was associated with less mortality., Conclusions: A new STS ACSD risk model to predict mortality and morbidity after ascending aneurysm surgery has been developed, and predictors of better and worse outcomes have been identified., Competing Interests: Disclosures Nimesh Desai reports a relationship with W. L. Gore & Associates Inc that includes: consulting or advisory; with Terumo Medical Corp that includes: consulting or advisory; with Artivion, Inc that includes: consulting or advisory; with Edwards Lifesciences Corporation that includes: consulting or advisory; and with Baxter International Inc that includes: consulting or advisory. Hiroo Takayama reports a relationship with Edwards Lifesciences which includes consulting and advisory and W.L. Gore which includes consulting and advisory. Eric Roselli reports a relationship with Artivion, Inc that includes: consulting or advisory and a licensing agreement; with Cook Medical Inc that includes: consulting or advisory; with Edwards Lifesciences Corporation that includes: consulting or advisory; with W. L. Gore & Associates Inc that includes: consulting or advisory; with Medtronic that includes: consulting or advisory; with JenaValve Technology Inc that includes: speaking and lecture fees; with LifeNet Inc that includes: speaking and lecture fees; and with Terumo Aortic that includes: speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

The American Society of Clinical Oncology (ASCO) updated the guidelines for the treatment of advanced gastroesophageal (GE) cancer in 2023, signifying a major shift towards targeted therapeutics and precision medicine. This article serves as an imaging-based review of recent developments in the care of patients with GE cancer. We cover the epidemiology, the developing treatment paradigms, and the imaging assessment of GE malignancy. In addition, this review aims to familiarize radiologists with the unique adverse effects pertaining to therapeutics, surgeries, radiation therapies, and associated imaging corollaries. A case-based approach will be used to both explore the efficacy of modern treatments and demonstrate their adverse effects, such as chemotherapy-associated pneumonitis, radiation esophagitis, and anastomotic failure. With this comprehensive exploration of gastroesophageal cancer, radiologists will be equipped with the essential tools to inform the treatment decisions made by medical oncologists, radiation oncologists, and surgical oncologists in the new era of precision medicine., Competing Interests: Declarations. Conflict of interest: The authors declare no conflict of interest., (© 2024. The Author(s).)

Background: An update of the 2007 and 2014 surveys of the American Brachytherapy Society (ABS) will elucidate current practice patterns of cervical cancer brachytherapy., Methods: A 40-question survey was sent to all ABS members in June-July 2023 and February 2024; 167 responses were received, with 140 used for analysis. Results were compared to the 2014 survey using chi-squared testing. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) with 95% confidence intervals (CI) for outcomes of interest., Results: Compared to 2014, MRI use for treatment planning of the first brachytherapy fraction increased from 34% to 63% (p < 0.001), prescription to the high-risk clinical target volume (HR-CTV) increased from 52% to 94% (p < 0.001), while Point A prescription decreased from 42% to 16% (p < 0.001). Additionally, procedural guidance with ultrasound significantly increased (79% vs. 32%, p < 0.001) along with the use of interstitial needles (always or nearly always, >80%) (29% vs. 4%, p < 0.001). MRI availability around the time of procedure was the largest challenge to incorporating MRI into brachytherapy treatment planning. Compared to those with MRI access reserved specifically for Radiation Oncology, respondents with shared-access or out-of-department MRI were less likely to obtain treatment planning MRIs for each brachytherapy fraction (22% vs. 75%; aOR 0.10 [95% CI, 0.03-0.30], p < 0.001)., Conclusion: For cervix cancer brachytherapy there has been significant increase in the use of MRI-based volumetric brachytherapy treatment planning, ultrasound guidance during procedures and the addition of interstitial needles. These advancements in practice patterns are congruent with published consensus guidelines and ongoing training initiatives. However, MRI access and lack of easy availability continue to be significant challenges for optimizing cervix brachytherapy., (Copyright © 2024 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the representation of women as speakers at U.S. radiology annual scientific meetings (ASM)., Methods: This retrospective study analyzed speaker demographic data from the Society of Interventional Radiology (SIR) and American Roentgen Ray Society (ARRS) ASM between 2019 and 2022. Speaker gender was identified through publicly available profiles, and the percentage of female speakers was calculated for each year. Statistical significance of trends was determined using chi-squared tests, and linear regression analysis was employed to assess trends and to predict future representation., Results: At the SIR ASM, female representation increased from 20.0 % (67 of 334 speakers) in 2019 to 26.5 % (90 of 340 speakers) in 2022. Chi-squared tests showed a statistically significant increase when adjusted for the percentage of female membership. At the ARRS ASM, female representation fluctuated, dropping from 36.6 % (104 of 284 speakers) in 2019 to 17.7 % (43 of 243 speakers) in 2020, then rising to 48.5 % (190 of 392 speakers) in 2022. A chi-squared test revealed significant variation in female representation across the years (p < 0.0001)., Conclusion: While both ASM showed an overall positive trend in female speaker representation, SIR demonstrated consistent increases, whereas ARRS exhibited significant fluctuations. Continued efforts in advocacy and targeted interventions are needed to sustain progress and address the gender gap in radiology., (Copyright © 2024. Published by Elsevier Inc.)

A recent American College of Obstetricians and Gynecologists Clinical Practice Update continues to recommend targeted (as opposed to universal) screening for pregestational diabetes, no longer recommends screening for early gestational diabetes mellitus (GDM), and provides updated guidelines for immediate postpartum testing for diabetes in patients with GDM. Here, we present data that the targeted screening paradigm, which has repeatedly been shown to fail in practice because of its complexity, no longer makes sense in the context of the high and rising prevalence of diabetes and diabetic risk factors, and we argue that the time has come for universal early pregnancy screening for pregestational diabetes. Furthermore, the recommendation against early screening for GDM is based on 2021 U.S. Preventive Services Task Force guidance, which in turn is based almost entirely on a single underpowered study that excluded individuals at highest risk and does not account for more recent research showing benefits of early diagnosis and treatment. Universal early pregnancy screening for pregestational diabetes may also help to identify patients at risk who will benefit from early GDM diagnosis and treatment and may provide rationale for prioritizing postpartum diabetes testing., Competing Interests: Financial Disclosure The authors did not report any potential conflicts of interest., (Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Orthopedic advocacy is an indispensable tool for surgeons to help shape health care policies and address the mounting challenges they face in providing quality care to patients and maintaining a sustainable practice. Health care advocacy embodies a commitment to fair health care access and provider autonomy, employs diverse strategies to amplify patient and doctor voices, and advances public health imperatives. Orthopedic advocacy confronts a myriad of legislative challenges specific to the orthopedic specialty, from reimbursement complexities to regulatory burdens. This necessitates strategic alliances and grassroots engagement to effectuate meaningful change. By fostering public awareness and legislative engagement, individual surgeons can drive transformative reforms, ensuring orthopedic practice aligns with patient needs and advances health care impartiality. The American Academy of Orthopaedic Surgeons advocacy program along with its subspecialty affiliates, such as the American Shoulder and Elbow Surgeons political advocacy committee, have a structured approach to advocacy comprising government relations, grassroots mobilization, and educational initiatives. This review explores the basis of health care advocacy including the structure of the American Academy of Orthopaedic Surgeons advocacy program. In addition to highlighting key legislative issues facing front-line orthopedic surgeons, this manuscript provides some provisional insights on how individual surgeons can engage in orthopedic advocacy to drive positive change., (Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Objective: This report evaluates rheumatologists' stated adherence to and agreement with the 2020 American College of Rheumatology (ACR) Guideline for the Management of Gout., Methods: A 57-item questionnaire was administered to a sample of US rheumatologists. Stated adherence scores were based on several guideline recommendations reported to be followed by rheumatologists in practice, whereas stated agreement scores were based on whether respondents always followed the recommendations., Results: All 201 rheumatologists approached completed the questionnaire. The mean overall stated adherence score was 11.5 (maximum 15), whereas the mean overall stated agreement score was 7.7 (maximum 14). Less experienced rheumatologists (≤ 8 yrs; n = 49) were likely to claim adherence to more individual ACR recommendations than those with more experience (> 8 yrs; n = 152; mean stated adherence score: 12.3 vs 11.3; P ≤ 0.05). Rheumatologists who claimed to see ≤ 75 patients with gout in 6 months (n = 66) had a mean stated adherence score of 12.1 vs 11.2 for those who claimed to have seen > 75 patients ( P ≤ 0.05). Approximately 78% of rheumatologists claimed to follow the guideline for initiating urate-lowering therapy (ULT), and 89% were likely to prescribe allopurinol as a first-line ULT. Claimed adherence to recommendations for dosing was lower (febuxostat: 43%; allopurinol: 39%). Rheumatologists from academic settings were more likely to prescribe an interleukin-1 inhibitor for gout flares., Conclusion: The self-reported practice of the surveyed US rheumatologists was generally concordant with the 2020 ACR Guideline for the Management of Gout. However, there were gaps in guideline knowledge and stated adherence among rheumatologists, mainly concerning the dosing of treatment regimens., (Copyright © 2024 by the Journal of Rheumatology.)

Background and Aims: Training in interventional endoscopy is offered by nonaccredited advanced endoscopy fellowship programs (AEFPs). The number of these programs has increased dramatically with a concurrent increase in the breadth and complexity of interventional endoscopy procedures. Accreditation is governed by competency-based education, yet what constitutes a "high-quality" nonaccredited AEFP has not been defined. Using an evidence-based consensus process, we aimed to establish standards for AEFPs., Methods: The RAND UCLA appropriateness method, a well-described modified Delphi process to develop quality indicators, was used. A task force established by the American Society for Gastrointestinal Endoscopy drafted potential quality indicators (structure, process, and outcome) in 6 categories: activity preceding training; structure of AEFPs; training in ERCP, EUS, and EMR; and luminal stent placement. Three rounds of iterative feedback from 20 experts were conducted. Round 0 involved discussion of project details. In round 1, experts independently ranked proposed quality indicators on a 9-point interval scale ranging from highly inappropriate (1) to highly appropriate (9). Next, proposed quality indicators were discussed and reworded in a group meeting followed by round 2, in which experts independently reranked proposed quality indicators and provided benchmarks (when applicable). The median score for each quality indicator was calculated. Mean absolute deviation from the median was calculated, and appropriateness of potential quality indicators was assessed using the BIOMED concerted action on appropriateness definition, P value method, and interpercentile range adjusted for symmetry definition. A quality indicator was deemed appropriate if the median score was ≥7 and met criteria for appropriateness using all 3 defined statistical methods., Results: Of 89 proposed quality indicators, 37 statements met criteria as appropriate for a quality indicator (activity preceding training, 2; structure of AEFPs, 10; training in ERCP, 7; training in EUS, 8; training in EMR, 7; luminal stent placement, 3). Minimum thresholds were defined for 19 relevant quality indicators for number of trainers, procedures during fellowship, and procedures before assessment of competence. Among the final appropriate quality indicators were that all trainees should undergo qualitative and quantitative competence assessments using validated tools at least quarterly with documented feedback throughout the training period and that trainees should track outcomes and relevant quality metrics for specific procedures., Conclusions: This consensus process using validated methodology established standards for an AEFP in an effort to ensure adequate training in the most commonly taught interventional endoscopic procedures (ERCP, EUS, EMR, and luminal stent placement) during fellowship. An important component of an AEFP is the use of competency-based assessments that are compliant with the Accreditation Council for Graduate Medical Education's Next Accreditation System, with the goal of ensuring that trainees achieve specific milestones in their progression to achieving cognitive and technical competency., Competing Interests: Disclosure The following authors disclosed financial relationships: G. A. Cote: Consultant for Interpace Diagnostics and Olympus Corporation; research support from Abbvie Pharmaceuticals. R. N. Keswani: Consultant for Medtronic and Boston Scientific. R. H. Yadlapati: Consultant for Medtronic, Phathom Pharmaceuticals, and StatLinkMD; research support from Ironwood Pharmaceuticals; advisory board with stock options in RJS Mediagnostix. T. M. Berzin: Consultant for Medtronic, Boston Scientific, Wision AI, Magentiq Eye, and RSIP Vision. P. Chahal: Consultant for Boston Scientific and Medtronic. J. Cohen: Consultant for Olympus America and Micro-Tech; stock owner in GI Windows, Virtual Health Partners, and Rom-Tech; owner of MD Medical Navigators. W. J. Coyle: Speaker for Abbvie, Pharm and Regeneron, and Pharm D. Early: Scientific advisory board for Guardant Health. N. M. Guda: Consultant for Boston Scientific and Hemostasis Inc LLC; speaker for Lupin Pharmaceuticals, India. S. Inamdar: Consultant for Pentax Medical. E. J. Shin: Consultant for Boston Scientific. U. D. Siddiqui: Consultant and speaker for Olympus, Boston Scientific, ConMed, Medtronic, and Cook Medical; research support from Olympus and Boston Scientific. All other authors disclosed no financial relationships., (Copyright © 2025 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

Background: Structured preparation is necessary to conduct quality improvement (QI) strategies that are relevant to the problem, feasible, appropriately resourced, and potentially effective. Recent work suggests that improvement efforts are suboptimally conducted. Our goal was to determine how well preparation for surgical QI is undertaken, including detailing the problem, setting project goals, and planning an intervention., Study Design: This retrospective cross-sectional study included QI efforts submitted in 2019 to the American College of Surgeons (ACS) during review for accreditation across 5 ACS Quality Programs: Children's Surgery Verification, the Commission on Cancer, the MBSAQIP, the National Accreditation Program for Breast Centers, and the Trauma Verification Program. Projects were scored for alignment with three components of the preconduct phase of the ACS Quality Framework: problem detailing, goal specification, and strategic planning., Results: A total of 242 projects satisfied inclusion criteria and were scored. Most projects in the final cohort were from MBSAQIP (36%), Commission on Cancer (31%), or National Accreditation Program for Breast Centers (29%) programs. The average overall preconduct score was 52% (SD 17). On average, projects performed best in the "goal specification" component (65%, SD 27), followed by "problem detailing" (52%, SD 16), and "strategic planning" (44%, SD 25). Within these components, identification of possible limitations (5%) and consideration of contextual issues (12%) were among the least frequently reported items., Conclusions: Thorough planning is a critical component of effective QI, and our study reflects significant opportunity for its improvement. The ACS Quality Framework may serve as a guide to improve QI planning, thereby promoting efficiency and effectiveness of these efforts., (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)

The ARS brain committee recommends that vorasidenib may be appropriate for recurrent or residual IDH-mutant grade 2 oligodendroglioma or astrocytoma. Vorasidenib is usually not appropriate for completely resected grade 2 oligodendroglioma or astrocytoma, any grade 3 oligodendroglioma or astrocytoma, or combined with radiotherapy and/or chemotherapy for any grade 2-3 glioma., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Dr. McClelland receives research funding from the National Institutes of Health (National Cancer for Advancing Translational Sciences), University Hospitals Minority Faculty Career Development Award, the Robert Winn Diversity in Clinical Trials Career Development Award (sponsored by the Bristol Myers Squibb Foundation), the Case Comprehensive Cancer Center Accelerator Pilot Project Award, the Gilead Sciences Research Scholars Program in Solid Tumors Award, the Radiation Oncology Institute, and the Susan G Komen Career Catalyst Research Grant. Dr. Wang reports grants from Genentech and Varian, royalties from Wolters Kluwer, consulting fees from AbbVie, Cancer Panels, Elekta, Merck, RTOG Foundation, and Iylon Precision, honoraria from Cancer Panels, DSMB/Advisory participation with Iylon Precision, and stock or options from Doximity, outside of the submitted work. Dr. McGranahan reports clinical Trial Support (institutional) from Servier (I.R.I.S.), Biomimetix, Denovo Biopharma, Biohaven pharmaceuticals, Chimerix, Novocure, Vigeo and Consulting/Advisory Board: Servier (I.R.I.S.). Dr. Eric Lehrer is on the Advisory Board for Servier Pharmaceuticals (all funds paid to Mayo Clinic). Dr. Palmer is a consultant for Servier (not in scope of work) and consultant for Icotec and Novocure. All remaining authors have declared no conflicts of interest.]., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Recently, there has been an increase in the representation of women within the cardiothoracic surgery workforce, with discussions about gender equity garnering interest. We sought to identify whether this increase is accompanied by commensurate selection for representation at national meetings., Methods: Online archives of The Society of Thoracic Surgeons (STS) Annual Meetings were reviewed from 2015 to 2024. Data regarding the moderator's gender were abstracted. The gender distribution of moderators across the various session categories was surveyed, and subgroup analyses were performed., Results: During the years of study, the STS Annual Meeting Taskforce selected 983 moderators to participate in the conference, including 218 women. The representation of women moderators demonstrated a favorable, upward trend. In 2015, 12.1% of moderators were women, with a consistent rate from 2015 to 2018. There was a noticeable rise in invited women moderators in 2019, with 25.4% of moderators being women. This proportion increased to 36.9% women in 2024. General Thoracic sessions have consistently included a greater percentage of women moderators compared with other sessions. Other topic areas, such as Education and Quality Improvement and Critical Care, transitioned to greater representation of women in recent years., Conclusions: There has been an increase over time in women moderators selected for participation in the STS Annual Meeting, with progress in gender diversity seen in most session types. Although the overall proportion of women within cardiothoracic surgery remains low, the STS has increasingly worked toward encouraging inclusivity. Efforts to further support well-rounded representation are of important benefit., Competing Interests: Disclosures Neel Chudgar reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory. Mara Antonoff reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory; and with Merck & Co Inc that includes: consulting or advisory. Brendon Stiles reports a relationship with Gala Therapeutics that includes: consulting or advisory; with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory; with Bristol-Myers Squibb Co that includes: consulting or advisory; with Bristol-Myers Squibb Foundation that includes: consulting or advisory; with Pfizer Inc that includes: consulting or advisory; with Genentech Inc that includes: consulting or advisory; with Lung Cancer Research Foundation that includes: consulting or advisory; with Medtronic Inc that includes: consulting or advisory; and with Arcus Biosciences Inc that includes: consulting or advisory. The other authors have no conflicts of interest to disclose. Declaration of Generative AI and AI-Assisted Technologies During the preparation of this work the authors used ChatGPT to proofread the text. After using this tool/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication., (Published by Elsevier Inc.)

Abstract: In 2003, the Institute of Medicine noted the need to improve workforce diversity. The American Society of Hematology (ASH) responded by developing the Minority Recruitment Initiative (MRI) to recruit diverse physicians/scientists into hematology. We evaluated the outcomes of the program. From 2004 to 2022, there were 405 awardees. Compared with national estimates, MRI awardees were less likely to discontinue their degree programs. MRI graduate student awardees had 0% attrition (97.5% confidence interval [CI], 10.6), whereas the national minority graduate student attrition was 36%. Medical student awardees had 2.2% (95% CI, 0.61-5.6) attrition, compared with the minority medical school attrition of 5.6%. Awardees were more likely than expected to pursue hematology-oncology (5.7% minority national estimate) because 14.4% (95% CI, 8.1-23.0) of medical student awardees and 88.5% (95% CI, 70.0-97.6) of early career awardees remain in the field. ASH has developed a successful program, but continued efforts are needed to advance equity in hematology., (© 2024 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)

In December 2023, the Trauma Professional Committee of the American Society of Surgeons officially released the seventh edition of "Resources for Optimal Care of the Injured Patient (2022 Stan-dards)". Compared to the sixth edition of the standards, the main updated content of the seventh edition includes ten aspects: (1) trauma centers need to meet new personnel configuration and qualification requirements, (2) trauma centers need to develop more structured and effective trauma treatment effectiveness improvement and patient safety plans, (3) trauma centers need to develop data quality plans, (4) trauma centers need to develop new diagnosis and treatment plans for specific patients, (5) trauma centers need to have new professional knowledge, (6) trauma centers need to meet new response time and resource availability standards, (7) trauma centers need to meet new academic and scientific requirements, (8) tertiary trauma centers need corresponding qualification certificates if providing neurological trauma treatment, (9) new requirements for pediatric trauma centers, (10) the fourth level trauma center standards. The research literature published by scholars in the field of trauma in the past decade has provided sufficient evidence-based medicine evidence for updating content. The article introduces and analyzes the updates in the seventh edition standards in light of the available evidence.

Background: Sudden cardiac death (SCD) is a major concern in patients with hypertrophic cardiomyopathy (HCM). The American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) have different guidelines for SCD risk stratification. Their comparative performance in diverse populations remains uncertain., Objective: Evaluate the performance of the 2020 ACC/AHA and 2014 ESC guidelines for SCD stratification in a Brazilian cohort with HCM., Methods: This retrospective cohort study included patients diagnosed with HCM who were followed in a dedicated clinic at a tertiary hospital in Brazil. The primary outcome was SCD, aborted cardiac arrest due to ventricular fibrillation (VF), sustained ventricular tachycardia (SVT), an episode of VF or SVT, or appropriate ICD therapy. Risk prediction models were assessed using the C-index., Results: A total of 187 patients were included, with a mean follow-up of 8.3 years. The 2020 ACC/AHA guidelines classified 106 (56%) patients as high-risk for SCD, while the 2014 ESC guidelines identified 54 (29%). The primary outcome occurred in 12% of the high-risk group identified by the ACC/AHA guidelines and 13% of the high-risk group identified by the ESC guidelines. Both guidelines showed low discriminatory power for SCD risk in this Brazilian cohort, with AUC values of 0.634 and 0.581 for the ACC/AHA and ESC guidelines, respectively., Conclusions: The 2020 ACC/AHA and 2014 ESC guidelines have limitations in predicting SCD events and defining ICD indications in Brazilian HCM patients. Further studies are needed to refine risk stratification and optimize SCD prevention in this population., Competing Interests: All authors declare that there are no conflicts of interest related to this study. We have no financial or personal relationships with any entities that could have influenced the work reported in this paper. Specifically, no author has shareholding in or has received grants, consultancy fees, or any other form of compensation from companies whose products are featured in this manuscript or that manufacture competing products. This statement is made in accordance with the requirements of the European Journal of Heart Failure and the ICMJE Conflicts of Interest disclosure form. Each author has submitted a completed disclosure form along with this submission., (Copyright: © 2024 The Author(s).)

Importance: Pediatric patients with complex medical problems benefit from pediatric sub-specialty care; however, a significant proportion of children live greater than 80 mi. away from pediatric sub-specialty care., Objective: To identify current knowledge gaps and outline concrete next steps to make progress on issues that have persistently challenged the pediatric nephrology workforce., Evidence Review: Workforce Summit 2.0 employed the round table format and methodology for consensus building using adapted Delphi principles. Content domains were identified via input from the ASPN Workforce Committee, the ASPN's 2023 Strategic Plan survey, the ASPN's Pediatric Nephrology Division Directors survey, and ongoing feedback from ASPN members. Working groups met prior to the Summit to conduct an organized literature review and establish key questions to be addressed. The Summit was held in-person in November 2023. During the Summit, work groups presented their preliminary findings, and the at-large group developed the key action statements and future directions., Findings: A holistic appraisal of the effort required to cover inpatient and outpatient sub-specialty care will help define faculty effort and time distribution. Most pediatric nephrologists practice in academic settings, so work beyond clinical care including education, research, advocacy, and administrative/service tasks may form a substantial amount of a faculty member's time and effort. An academic relative value unit (RVU) may assist in creating a more inclusive assessment of their contributions to their academic practice. Pediatric sub-specialties, such as nephrology, contribute to the clinical mission and care of their institutions beyond their direct billable RVUs. Advocacy throughout the field of pediatrics is necessary in order for reimbursement of pediatric sub-specialist care to accurately reflect the time and effort required to address complex care needs. Flexible, individualized training pathways may improve recruitment into sub-specialty fields such as nephrology., Conclusions and Relevance: The workforce crisis facing the pediatric nephrology field is echoed throughout many pediatric sub-specialties. Efforts to improve recruitment, retention, and reimbursement are necessary to improve the care delivered to pediatric patients., (© 2024. The Author(s).)

Background: Contemporary national outcomes of open and endovascular aortic repair for descending thoracic aortic aneurysms (DTAAs) and thoracoabdominal aortic aneurysms (TAAAs) are unclear. This study evaluated this issue by using The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD)., Methods: From July 1, 2017 to June 30, 2022, study investigators identified 3522 adults who underwent planned DTAA repair (open, 328; endovascular, 1895) or TAAA repair (open, 870; endovascular, 429), after excluding ascending aorta or aortic arch aneurysms (zone 0, 1, or 2), interventions with a proximal extent in zone 0 or zone 1, juxtarenal or infrarenal aortic interventions, hybrid procedures, aortic trauma, and aortic infection., Results: Most DTAA interventions (85.2%) were endovascular repairs, whereas most TAAA interventions were open repairs (66.9%). For DTAA interventions, the operative mortality, permanent stroke rate, and rate of spinal cord injury were 4.2%, 3.8%, and 2.4% for endovascular repairs and 9.2%, 8.5%, and 4.6% for open repairs, respectively (all P < .05). For TAAA interventions, the operative mortality, permanent stroke rate, and rate of spinal cord injury were 6.5%, 2.1%, and 3.0% for endovascular repairs and 11.7%, 6.0%, and 12.2% for open repairs, respectively (all P < .05). Increasing annual open TAAA repair volume was associated with lower odds of experiencing the composite of operative mortality, permanent stroke, or spinal cord injury., Conclusions: On the basis of STS ACSD data, endovascular repair was the predominant approach for treating DTAA, whereas most patients undergoing TAAA interventions had an open surgical repair. Outcome differences between open and endovascular approaches may be related to patient selection. Increasing center experience with open TAAA repair is associated with improved outcomes., Competing Interests: Disclosures The authors have no conflicts of interest to disclose., (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Study Objective: To assess willingness to provide medication abortion among North American Society for Pediatric and Adolescent Gynecology (NASPAG) clinicians caring for adolescents and young adults (AYA) following Dobbs v. Jackson Women's Health Organization., Design: Cross-sectional online survey., Methods: Potential participants received an e-mail invitation via the NASPAG listserv. A 43-item questionnaire queried demographics, practice setting, abortion training and practice, willingness to provide medication abortion, potential or real barriers to providing medication abortion, and sentiments of abortion. Descriptive statistics, χ 2 , and Fisher's exact tests were used., Results: Of the 70 participants, 51% were willing to provide a medication abortion for an adolescent who requested it in their clinical practice. The most common barriers to providing medication abortion were legislative restrictions (47%) and dispensing pills from clinic (33%). Participants' willingness to provide a medication abortion differed by type of practice (P = .001), availability of mifepristone (P = .006), perception of state's abortion policy (P = .001), concern about legislative restrictions (P = .008), experience providing abortion (P = .04), and receipt of medication abortion training (P = .02). Willingness to provide medication abortion also differed based on various sentiments of abortion measured but not on opinion regarding legality of abortion for adolescents (P = .49)., Conclusions: Perception of state's abortion rights and concern about legislative restrictions influenced NASPAG clinicians' willingness to provide medication abortion for adolescents. Interventions to minimize legislative interference with medical care, increase abortion training, and implement medication abortion in pediatric settings may expand AYA medication abortion access., Competing Interests: Conflicts of Interest Statement K.F. is a consultant for Medicines360. No other authors have any conflicts of interest to disclose., (Copyright © 2024. Published by Elsevier Inc.)

In this first annual review article, the American Society for Apheresis (ASFA) Attending Physician Subcommittee (APSc) of the Physicians' Committee (PC) curated key apheresis literature in 2023 and presented their choices for the 10 most seminal apheresis articles. PubMed and OVID search engines were used to identify manuscripts from four topic areas: donor apheresis, therapeutic apheresis, education, and cellular therapy. To further identify seminal criteria, they had to present at least one of the following: novel findings, practice-altering outcomes, international scope, randomized controlled trial, relevant to current clinical practice, and/or provide evidence for category III or IV indications based on the ASFA ninth special issue of the Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach. Inclusion criteria included: full-length, peer-reviewed, English language, and human subjects. Case reports, review articles, and meta-analyses were excluded., (© 2024 Wiley Periodicals LLC.)

Aim of the Study: The American Society of Clinical Oncology (ASCO) hosts an annual conference and is one of the largest medical conferences globally. For ASCO 2024, they selected 25 Featured Voices, advertising them as individuals to follow on Twitter/X throughout the conference. The aim of this study was to characterize tweets from each of the 25 featured individuals., Brief Summary of the Methods: From May 16, 2024 through June 19, 2024 we filtered tweets by using the twitter advanced search tool and applying the following criteria in the tweet text: #ASCO OR #ASCO24 OR #ASCO2024. Tweets were classified as being about research (yes or no) and if media was included (yes or no). Additional information about research related tweets was gathered, such as whether the research was observational or interventional. If it was interventional, we characterized whether the tweet was supportive, critical, or neutral of the research., Results: We find that 229 (28.3 %) of 810 tweets commented on research. Of the 229 research related tweets, 136 (59.4 %) were related to interventional trials of which they were supportive 65.3 % of the time. Media was included in 280 (34.6 %) of 810 tweets. 219 were photos of a person and 80 were selfies., Conclusion: ASCO Featured Voices tweeted more photos, including selfies (n=299), than commentary about research (n=229). When research was referenced, individuals were rarely critical. Trials presented at ASCO have the ability to impact guidelines, so it is important that they are appraised critically and discussed in an unbiased way. How Featured Voices are chosen requires further scrutiny., Policy Summary Statement at the End: ASCO should disclose financial relationships in the future when selecting Featured Voices to represent the organization and provide insight., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: In 2023 the American Urological Association (AUA) requested an Update Literature Review (ULR) to incorporate new evidence generated since the 2020 publication of this Guideline. The resulting 2024 Guideline Amendment addresses updated recommendations to provide guidance on the appropriate evaluation and management of the male partner in an infertile couple., Materials and Methods: In 2023, the Male Infertility Guideline was updated through the AUA amendment process in which newly published literature is reviewed and integrated into previously published guidelines. An updated literature search identified 4093 new abstracts. Following initial abstract screening, 125 eligible study abstracts met inclusion criteria. On data extraction, 22 studies of interest were included in the final evidence base to inform the Guideline amendment., Results: The Panel developed evidence- and consensus-based statements based on an updated review to provide guidance on evaluation and management of male infertility. These updates are detailed herein., Conclusions: This update provides several new insights, including revised thresholds for Y-chromosome microdeletion testing, indications for pelvic magnetic resonance imaging (MRI) imaging in infertile males, and guidance regarding the use of testicular sperm in nonazoospermic males. This Guideline will require further review as the diagnostic and treatment options in this space continue to evolve.

Objective: To develop and compare various models for risk stratification in chromophobe renal cell carcinoma (chrRCC). Models have been developed to predict progression-free (PFS) and cancer-specific survival (CSS) following surgery for localized renal cell carcinoma (RCC). Notably, chromophobe RCC (chrRCC) is not included in American Urological Association (AUA) risk stratification, as nuclear grading is not recommended., Methods: We queried our institutional registry to identify patients managed surgically for unilateral, sporadic, M0, chrRCC from 1970-2012. AUA risk groups were defined using reported criteria, excluding grade, and were compared to the Mayo system incorporating nodal involvement, perinephric/renal sinus fat invasion, and sarcomatoid differentiation. PFS and CSS were estimated using the Kaplan-Meier method. Predictive ability was summarized using c-indexes from Cox proportional hazard regression models., Results: A total of 257 patients were identified. Thirty-nine patients experienced disease progression at a median 30 months (IQR 5.0-84) and 25 died from chrRCC at a median 34 months (IQR 15-79) following surgery. PFS and CSS rates at 10 years after surgery were 84% and 90%, respectively. C-indexes for modified AUA and Mayo risk groups were similar at 0.76 and 0.75, respectively, for PFS, and 0.77 and 0.76, respectively for CSS., Conclusion: The modified AUA and Mayo risk stratification systems have similarly robust c-indexes for PFS and CSS in chrRCC. These models can be used to counsel patients based on pathologic features, inform clinicians on appropriate follow-up pathways, and identify patients at risk of disease progression for enrollment in adjuvant systemic therapy trials., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

In 2015, the ATA updated the guidelines to advocate for a lobectomy for tumors <1.0 ​cm and total thyroidectomy for tumors >4.0 ​cm. Treatment for tumors of intermediate size 1.0-4.0 ​cm is dependent on high-risk characteristics. There is limited research comparing the impact of the updated ATA guidelines on clinical practice on intermediate-sized tumors. In this study, the impact of the 2015 ATA guidelines on the surgical treatment of intermediated-sized FTC will be evaluated using the Surveillance, Epidemiology, and End Results (SEER) database. A total of 9983 patients were included; 7769 patients (74.1 ​%) were diagnosed pre-ATA guidelines and 2709 patients (25.9 ​%) post-ATA guidelines. The mean rate of lobectomy for intermediate-sized tumors was 22.1 ​% which increased to 33.4 ​% post-ATA updates. The results of the logistic regression showed the rate of lobectomy increased significantly in the post-ATA changes period (p ​< ​0.001). Future research could benefit from evaluating how these trends impact patient outcome measures., Competing Interests: Declaration of competing interest 1. Laura M. Cogua: No disclosures to report. 2. Connor J. Tupper: No disclosures to report. 3. Peter T. Silberstein: No disclosures to report. 4. Kathryn E. Coan: No disclosures to report., (Copyright © 2024 Elsevier Inc. All rights reserved.)

In 2017, the American College of Radiology introduced the US Liver Imaging Reporting and Data System (LI-RADS) as a framework for US surveillance of patients at risk for developing hepatocellular carcinoma. This has aided in the standardization of technique, clinical reporting, patient management, data collection, and research. Emerging evidence has helped inform changes to the algorithm, now released as LI-RADS US Surveillance version 2024. The updated algorithm, the rationale for changes, and its alignment with the 2023 American Association for the Study of Liver Diseases Practice Guidance are presented., (© RSNA, 2024.)

Rationale: For spirometry interpretation, the European Respiratory Society (ERS) and American Thoracic Society (ATS) recommend using z -scores, and the ATS has recommended using Global Lung Initiative (GLI) "Global" race-neutral reference equations. However, these recommendations have been variably implemented, and the impact has not been widely assessed in clinical or research settings. Objectives: To evaluate the ERS/ATS classification of airflow obstruction severity. Methods: In COPDGene (Genetic Epidemiology of COPD Study) ( N  = 10,108), airflow obstruction has been defined by an FEV 1 /FVC ratio <0.70, with spirometric severity graded from class 1 to class 4 based on race-specific percent predicted (pp) FEV 1 cutoff points as recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). We compared the GOLD approach, using National Health and Nutrition Examination Survey III race-specific equations, versus the application of GLI Global equations using the ERS/ATS definition of airflow obstruction as an FEV 1 /FVC ratio below the lower limit of normal and z-score-based FEV 1 cutoff points of -1.645, -2.5, and -4 ("zGLI Global"). We tested the four-tier severity scheme for association with chronic obstructive pulmonary disease outcomes. Measurements and Main Results: The lowest agreement between ERS/ATS with zGLI Global and the GOLD classification was observed in individuals with milder disease (56.9% and 42.5% in GOLD stages 1 and 2, respectively), and race was a major determinant of redistribution. After adjustment for relevant covariates, zGLI Global distinguished all-cause mortality risk between normal spirometry and the first grade of chronic obstructive pulmonary disease (hazard ratio, 1.23; 95% confidence interval, 1.04-1.44; P  = 0.014) and showed a linear increase in exacerbation rates with increasing disease severity in comparison with GOLD. Conclusions: The zGLI Global severity classification outperformed the GOLD criteria in the discrimination of survival, exacerbations, and imaging characteristics.

Introduction: Artificial Intelligence (AI) is revolutionizing medical imaging and radiation therapy. AI-powered applications are being deployed to aid Medical Radiation Technologists (MRTs) in clinical workflows, decision-making, dose optimisation, and a wide range of other tasks. Exploring the levels of AI education provided across the United States is crucial to prepare future graduates to deliver the digital future. This study aims to assess educators' levels of AI knowledge, the current state of AI educational provisions, the perceived challenges around AI education, and important factors for future advancements., Methods: An online survey was electronically administered to all radiologic technologists in the American Society of Radiologic Technologists (ASRT) database who indicated that they had an educator role in the United States. This was distributed through the membership of the ASRT, from February to April 2023. All quantitative data was analysed using frequency and descriptive statistics. The survey's open-ended questions were analysed using a conceptual content analysis approach., Results: Out of 5,066 educators in the ASRT database, 373 valid responses were received, resulting in a response rate of 7.4%. Despite 84.5% of educators expressing the importance of teaching AI, 23.7% currently included AI in academic curricula. Of the 76.3% that did not include AI in their curricula, lack of AI knowledge among educators was the top reason for not integrating AI in education (59.1%). Similarly, AI-enabled tools were utilised by only 11.1% of the programs to assist teaching. The levels of trust in AI varied among educators., Conclusion: The study found that although US educators of MRTs have a good baseline knowledge of general concepts regarding AI, they could improve on the teaching and use of AI in their curricula. AI training and guidance, adequate time to develop educational resources, and funding and support from higher education institutions were key priorities as highlighted by educators., (Copyright © 2024. Published by Elsevier Inc.)

Background & Aims: We performed an updated systematic review and network meta-analysis to inform the 2024 American Gastroenterological Association (AGA) Clinical Guidelines on the management of moderate-to-severe ulcerative colitis (UC)., Methods: We searched multiple electronic databases through November 21, 2023, to identify randomized controlled trials in adults with moderate-to-severe UC, comparing different advanced therapies (tumor necrosis factor antagonists, vedolizumab, sphingosine-1-phosphate receptor modulators, interleukin 12/23 or selective interleukin 23 antagonists, and Janus kinase [JAK] inhibitors) against placebo or another active comparator. Our primary outcomes were induction and maintenance of clinical remission, and our secondary outcome was endoscopic improvement. We performed a network meta-analysis using a frequentist approach and applied Grading of Recommendations, Assessment, Development and Evaluation (GRADE) to appraise certainty of evidence., Results: After excluding JAK inhibitors as potential first-line treatment (in accordance with the United States Food and Drug Administration), low-certainty evidence supports clinically important benefit with infliximab, ozanimod, risankizumab, and guselkumab over adalimumab and mirikizumab for achieving remission with induction therapy in biologically naïve patients with moderate-to-severe UC, with risankizumab and ozanimod being ranked the highest for induction of clinical remission. With the inclusion of JAK inhibitors as first-line therapy, upadacitinib was more efficacious compared with all other medications except ozanimod and risankizumab, with low- to moderate-certainty evidence. In patients with prior biologic exposure, upadacitinib, tofacitinib, and ustekinumab were ranked highest for achieving remission., Conclusions: Using Grading of Recommendations, Assessment, Development and Evaluation to appraise quality of evidence, this updated network meta-analysis will be used to inform comparative efficacy and positioning of advanced therapies for the treatment of biologic-naïve and biologic-exposed patients with moderate-to-severe UC., (Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.)

The American College of Radiology Vesical Imaging-Reporting and Data System (VI-RADS) Steering Committee will strive to ensure high-quality imaging practices for bladder cancer (BC) and improve outcomes for BC patients. Work will involve evaluation of the current status of magnetic resonance imaging for BC and identify actionable areas to improve its utility in clinical practice. Current VI-RADS gaps related to unmet clinical needs, research areas to address, and future steps and timelines will be identified., (Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

As a professional duty, physicians are often required to publicly comment on health-related topics. However, ethical complexities can arise during discussions about high-profile individuals or events, especially in an era of rapid news cycles and digital media. The American Medical Association (AMA) has policies concerning physician commentary and media interactions, as does the American Psychiatric Association (i.e., the Goldwater Rule). Nevertheless, the extent to which other United States medical associations have adopted similar protocols remains underexplored. Focusing on non-psychiatric members of the AMA's policymaking body, the Federation of Medicine (FMMs), this study sought to analyze cross-speciality perspectives. Between January-March 2024, online resources for N = 122 FMMs were reviewed (e.g., professional codes and position statements), followed by email outreach to verify positions and garner further insights. n = 47 FMMs provided sufficient information for inclusion, cumulatively representing approximately 950,000 members. n = 16 FMMs (34%) had guidelines or policies regarding public commentary, generally emphasizing accuracy, consent, and confidentiality. Yet, for the majority of FMMs (n = 31/66%), no specific regulations were identified; these organizations did not cite any proprietary statutes or deferred to AMA materials. Moreover, existing FMM policies largely overlooked the impact of Artificial Intelligence and digital misinformation, warranting cross-specialty exchanges to uphold credible discourse amid societal and technological shifts., Competing Interests: Declarations. Competing interests: Maria A. Oquendo is a past president of the American Psychiatric Association. Dinesh Bhugra is a past president of the British Medical Association, the World Psychiatric Association, and the Royal College of Psychiatrists. The other authors have no competing interests to declare., (© 2024. The Author(s).)

For patients with rectal cancer, the standard approach of chemotherapy, radiation therapy, and surgery (trimodality therapy) is associated with significant long-term toxicity and/or colostomy for most patients. Patient options focused on quality of life (QOL) have dramatically improved, but there remains limited guidance regarding comparative effectiveness. This systematic review and associated guidelines evaluate how various treatment strategies compare to each other in terms of oncologic outcomes and QOL. Cochrane and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology were used to search for prospective and retrospective trials and meta-analyses of adequate quality within the Ovid Medline database between January 1, 2012, and June 15, 2023. These studies informed the expert panel, which rated the appropriateness of various treatments in 6 clinical scenarios through a well-established consensus methodology (modified Delphi). The search process yielded 197 articles that advised voting. Increasing data have shown that nonoperative management (NOM) and primary surgery result in QOL benefits noted over trimodality therapy without detriment to oncologic outcomes. For patients with rectal cancer for whom total mesorectal excision would result in permanent colostomy or inadequate bowel continence, NOM was strongly recommended as usually appropriate. Restaging with tumor response assessment approximately 8 to 12 weeks after completion of radiation therapy/chemoradiation therapy was deemed a necessary component of NOM. The panel recommended active surveillance in the setting of a near-complete or complete response. In the setting of NOM, 54 to 56 Gy in 27 to 31 fractions concurrent with chemotherapy and followed by consolidation chemotherapy was recommended. The panel strongly recommends primary surgery as usually appropriate for a T3N0 high rectal tumor for which low anterior resection and adequate bowel function is possible, with adjuvant chemotherapy considered if N+. Recent data support NOM and primary surgery as important options that should be offered to eligible patients. Considering the complexity of multidisciplinary management, patients should be discussed in a multidisciplinary setting, and therapy should be tailored to individual patient goals/values., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Importance: The American College of Surgeons (ACS) operative standards were established to detail critical elements of cancer surgery, reduce technical variation, and improve outcomes. Two of the 6 operative standards target adequate axillary surgery for breast cancer. The potential association of the operative standards with short-term oncologic outcomes, such as nodal yield and nodal positivity rates, is currently unknown., Objective: To evaluate the potential association of the ACS operative standards with short-term oncologic outcomes in breast cancer., Design, Setting, and Participants: A cohort study was performed using data on 1 201 317 women 18 years or older who underwent sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) for invasive breast cancer from January 1, 2012, to December 31, 2020. Patients were identified using the National Cancer Database (NCDB), a clinical oncology database encompassing approximately 70% of new cancer diagnoses, sourced from hospital registry data from 1317 facilities. Statistical analysis was performed from October 2023 to June 2024., Exposure: Sentinel lymph node biopsy or ALND., Main Outcomes and Measures: Reliability-adjusted facility-level lymph node yield and nodal positivity rate for each procedure were calculated using generalized linear mixed models, Poisson regression, and logistic regression with facility-level random intercepts., Results: The cohort included 1 201 317 women with a median age of 62 years (IQR, 53-70 years). Facility-level nodal yield ranged from 1 to 6 for SLNB and from 6 to 22 for ALND. Median facility-level nodal yield for SLNB was 2.6 (IQR, 2.3-3.0) and the nodal positivity rate for SLNB was 12.2% (IQR, 11.0%-13.7%), with rates ranging from 6% to 21%. A weak correlation between facility-level lymph node yield and nodal positivity was observed (Spearman correlation coefficient, 0.17). Median nodal upstaging rate (≥4 positive nodes) for ALND was 30.5% (IQR, 26.5%-35.0%), with rates ranging from 11% to 54%; median nodal yield was 12.2 (IQR, 10.9-13.6). A strong correlation between nodal yield and nodal upstaging rates was observed (Spearman correlation coefficient, 0.53)., Conclusions and Relevance: In this cohort study of women undergoing axillary surgery for invasive breast cancer, facility-level variation in lymph node yield was present for both SLNB and ALND, which could potentially be improved through the ACS operative standards. However, this variation had mixed associations with nodal positivity and upstaging rates, suggesting the association of the ACS operative standards with oncologic outcomes may be mixed.

The clinical syndrome of intracranial hypotension refers to the symptoms caused by cerebrospinal fluid hypovolemia and is primarily characterized by postural headaches, but can be associated with a multitude of other neurological symptoms. Imaging plays a critical role in helping to establish a diagnosis of intracranial hypotension, localize the source of cerebrospinal fluid leak, and assist in directing targeted treatments. Using the best available evidence, this document provides diagnostic imaging recommendations for the workup of intracranial hypotension across various clinical presentations. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation., (Copyright © 2024 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

Urothelial cancer is the second most common cancer, and cause of cancer death, related to the genitourinary tract. The goals of imaging for pretreatment staging of urothelial cancer are to evaluate for both local and distant spread of the cancer and assessing for synchronous sites of urothelial cancer in the upper tracts and bladder. For pretreatment staging of urothelial carcinoma, patients can be stratified into one of three groups: 1) nonmuscle invasive bladder cancer; 2) muscle invasive bladder cancer; and 3) upper urinary tract urothelial carcinoma. This document is a review of the current literature for urothelial cancer and resulting recommendations for pretreatment staging imaging. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation., (Copyright © 2024 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

Altered mental status (AMS) and coma are terms used to describe disorders of arousal and content of consciousness. AMS may account for up to 4% to 10% of chief complaints in the emergency department setting and is a common accompanying symptom for other presentations. AMS is not a diagnosis, but rather a term for symptoms of acute or chronic disordered mentation, including confusion, disorientation, lethargy, drowsiness, somnolence, unresponsiveness, agitation, altered behavior, inattention, hallucinations, delusions, and psychosis. Some of the most common disorders associated with AMS are underlying medical conditions, substance use, and mental disorders. This document focuses on the appropriateness of neuroimaging in adult patients presenting with AMS changes including new onset delirium or new onset psychosis. In these cases, imaging is often expedited for initial stabilization and to exclude an intracranial process requiring intervention. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation., (Copyright © 2024 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

Background: The increasing number of congenital heart disease patients undergoing reoperative cardiac surgery presents critical and growing challenges. Our objective was to evaluate the association between the number of prior cardiopulmonary bypass operations and operative mortality and morbidity in a national cohort., Methods: The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) was reviewed for index cardiac operations on cardiopulmonary bypass during 2016 to 2021. Infants and patients with functionally univentricular physiology were excluded. Multivariable logistic regression adjusted for covariates in the STS-CHSD Mortality Risk Model, the STS-European Association for Cardio-Thoracic Surgery (STAT) Mortality Category, and institutional volume., Results: Of 50,625 eligible operations, 22,100 (44%) were performed on patients with ≥1 prior cardiopulmonary bypass operations. Most common diagnoses were tetralogy of Fallot (4340 of 22,100 [19.6%]), pulmonary atresia/ventricular septal defect (1334 of 22,100 [6.0%]), and aortic stenosis (966 of 22,100 [4.4%]). Operative mortality correlated with number of prior cardiopulmonary bypass operations: 157 of 28,525 (0.6%) for 0, 127 of 13,488 (0.9%) for 1, 81 of 5,664 (1.4%) for 2, 61 of 2039 (3.0%) for 3, 35 of 623 (5.6%) for 4, 10 of 207 (4.8%) for 5, and 5 of 79 (6.3%) for ≥6 operations (P < .001). On multivariable analysis, patients with ≥3 prior cardiopulmonary bypass operations had higher risk of operative mortality (odds ratio, 2.31; P < .001) and major morbidity (odds ratio, 1.60; P < .001). Annual institutional volume and age were not associated with either outcome., Conclusions: Three or more prior cardiopulmonary bypass operations was an independent risk factor for operative mortality/morbidity, even after controlling for risk factors and institutional volume. Future research is needed to identify modifiable factors to optimize outcomes, particularly for those with ≥3 prior cardiopulmonary bypass operations., Competing Interests: Disclosures The authors have no conflicts of interest to disclose., (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Objective: To highlight the evolution of surgical morbidity and mortality conferences (MMCs) from the early 20 th century as a means of identifying surgeon error into current practices as identifying hospital-based system factors that contribute to adverse patient events. Further, to elucidate differences in the perception of MMCs between trainees and attending surgeons as well as differences in the structure of MMCs geographically and by institution type., Design: We developed a survey that was distributed to current American College of Surgeon members through Survey Monkey., Setting: Survey-based study., Participants: Current members of the American College of Surgeons, including Board of Governors, surgeons, and trainees., Results: There were a total of 1,396 responses to the survey, 814 (58%) from surgical trainees and 582 (42%) from attending surgeons. Both surgical trainees and attending surgeons noted that the most common day for MMCs was Wednesday and that the most common time for MMCs was before 7:30 AM. Further, most surgical trainees and attending surgeons noted that there was no structured format to their institution's MMCs and that increased attending surgeon engagement would make MMCs more educational. Significant variations in MMCs existed across both geographic region and by institution type., Conclusion: The results from this survey highlight key aspects of MMCs that contribute to their educational value. Staff engagement was noted to be the most educational aspect of MMCs. While geographic and institutional differences will likely persist, efforts should be made to increase staff engagement at MMCs in addition to a more structured approach., (Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Chronic obstructive pulmonary disease (COPD) is a major public health problem in the Americas (a region of the world comprising North, Central, and South America), although there is substantial variation in disease prevalence, morbidity, and mortality between and within nations. Across the Americas, COPD disproportionately affects vulnerable populations, including minoritized populations and impoverished persons, who are more likely to be exposed to risk factors such as tobacco use, air pollution, infections such as tuberculosis, and biomass smoke, but less likely to have adequate healthcare access. Management of COPD can be challenging across the Americas, with some barriers being specific to certain countries and others shared across the United States, Canada, and Latin America. Because most cases of COPD are undiagnosed because of suboptimal access to health care and pulmonary function testing and, thus, cannot be treated, increased access to spirometry would have a substantial impact on disease management across the Americas. For individuals who are diagnosed, access to medications and other interventions is quite variable across and within nations, even in those with universal healthcare systems, such as Canada and Brazil. This emphasizes the importance of collaborative treatment guidelines, which should be adapted for the healthcare systems and policies of each nation or region, as appropriate. To have a positive impact on COPD management in the Americas, we propose actionable items, including the need for all our respiratory societies to engage key stakeholders (e.g., patient-led organizations, professional societies, and governmental and nongovernmental agencies) while advocating for campaigns and policies to ensure clean air for all; eliminate tobacco use and enhance coverage for treatment of nicotine dependence; and improve access to early case finding, diagnosis, and treatment for all patients, including underserved and vulnerable populations.

This document summarizes the relevant literature for the selection of the initial imaging in five clinical scenarios in patients with suspected or known nonvariceal upper gastrointestinal bleeding (UGIB). These clinical scenarios include suspected nonvariceal UGIB without endoscopy performed; endoscopically confirmed nonvariceal UGIB with clear source but treatment not possible or continued bleeding after endoscopic treatment; endoscopically confirmed nonvariceal UGIB without a confirmed source; suspected nonvariceal UGIB with negative endoscopy; and postsurgical or post-traumatic nonvariceal UGIB when endoscopy is contraindicated. The appropriateness of imaging modalities as they apply to each clinical scenario is rated as usually appropriate, may be appropriate, and usually not appropriate to assist the selection of the most appropriate imaging modality in the corresponding clinical scenarios of nonvariceal UGIB. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation., (Copyright © 2024 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

Here we highlight the Alzheimer's Association's role since its inception, as a strategic collaborator with National Institutes of Health-National Institute on Aging in the development of the modern era of the Alzheimer's Movement and in making Alzheimer's disease (AD) a national priority in the United States by developing several initiatives to advance knowledge about the cause, diagnosis, and treatment of dementia. Among these collaborative undertakings, the Alzheimer's Disease Neuroimaging Initiative (ADNI) is an exemplary case, launched with groundwork by the Neuroimaging Working Group sponsored by the Association's Ronald and Nancy Reagan Research Institute on AD. The unique contribution of the Association to the development of ADNI includes participation as a member of ADNI's Private Partner Scientific Board and involvement in developing an AD biomarker standardization and validation subproject, which has led to a conceptual shift in the field to define AD based on its underlying biology. Furthermore, the creation of Worldwide ADNI (WW-ADNI) is highlighted, underscoring the global impact of these efforts. HIGHLIGHTS: The Alzheimer's Disease Neuroimaging Initiative (ADNI) is a keystone undertaking in the evolving landscape of Alzheimer's disease (AD) research, and is now in its fourth iteration. The Alzheimer's Association has partnered with ADNI since its inception. ADNI 4 and the Association continue to collaborate, ensuring representation within the study population., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Acute scrotum is a medical emergency that requires prompt accurate diagnosis to appropriately triage potentially surgical conditions. Numerous differential diagnoses with overlapping clinical presentations make this a diagnostic challenge. Ultrasound is the established first-line imaging modality for acute scrotal disease and can be used to diagnose most scrotal disorders promptly and with high accuracy. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation., (Copyright © 2024 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

To evaluate the utilization of the American Academy of Pediatrics' (AAP) cardiovascular screening questions within preparticipation physical evaluation forms from the 50 state high school athletic associations. We found that fewer than one-half of state forms incorporated all 10 AAP questions; moreover, a subset failed to adhere to criteria recommended by either the AAP or American Heart Association., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Professional society awards can substantially impact career trajectory of awardees in neurosurgery. Past studies have discussed the demographics of neurosurgery conference awardees in terms of gender and professional experience; however, a full assessment of awardee qualities and characteristics has yet to be studied., Objective: The goal of this study is to provide a comprehensive evaluation of neurosurgical society winners that focuses on gender, race, academic degrees, and institutional/geographic affiliation., Methods: Data of awardees across 14 neurosurgical societies from 2019 to 2022 was recorded. Variables recorded include professional society, award classification, year won, age, gender, race and ethnicity, board certification status, MD graduation year, degrees obtained, awardee home institution location, h-index, and NIH-funding. Statistical analysis was performed using IBM SPSS., Results: A total of 102 unique awards from 14 different societies between 2019 and 2022 were identified. Significantly more men (83 %) as compared to women (17 %) were awardees (p < 0.001). Awardees were significantly more likely to be Caucasian as compared to any other race (p < 0.001), and Caucasian awardees were more likely to be board certified and receive NIH funding. A higher proportion of male awardees had a PhD; however, the majority of all awardees were significantly more likely to not have a PhD or be board certified (p < 0.001). The majority of awardees were based in the Northeastern United States., Conclusions: Among winners of neurosurgical society awards, significant differences exist with respect to gender, race, ethnicity, degree type, and geographic location. Future research endeavors are needed to explore the reason for why these differences exist to ultimately develop strategies that promote equal opportunities for all neurosurgeons., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)