ed when administered 1 hour after. Roxadustat was well tolerated.

Concomitant administration of roxadustat with sevelamer carbonate or calcium acetate reduced exposure to roxadustat in healthy individuals. This effect was attenuated when roxadustat was administered ≥1 hour before or after either PB. Results from this study helped inform dosing and administration guidelines aimed at reducing interactions between roxadustat and these PBs. (Clin Ther. 2021;XXXXX-XXX) © 2021 Elsevier HS Journals, Inc.

Concomitant administration of roxadustat with sevelamer carbonate or calcium acetate reduced exposure to roxadustat in healthy individuals. This effect was attenuated when roxadustat was administered ≥1 hour before or after either PB. Results from this study helped inform dosing and administration guidelines aimed at reducing interactions between roxadustat and these PBs. (Clin Ther. 2021;XXXXX-XXX) © 2021 Elsevier HS Journals, Inc.

acquiring technical expertise for neonatal thoracoscopy is challenging. To address this, we designed a fully synthetic thoracoscopic simulator for which we established its construct validity.

three thoracoscopic tasks were assessed ring transfer, needle pass and incision of a blind upper esophageal pouch (EA cut). Participants watched instructional videos with accompanying written instructions for each task before having their attempt video recorded. All tasks were marked by three blinded pediatric surgeons using a modified Objective Structured Assessment of Technical Skills (OSATS). Scores were assessed using appropriate statistical analysis and inter-rater reliability was analyzed by interclass correlation coefficient (ICC).

23 participants completed the ring transfer and needle pass and 21 the EA cut 5 experts (consultant surgeons), 5 intermediate (registrars on a training program) and 13 novices (medical students, house surgeons or non-training registrars). All three tasks distinguished between novice and intermediate/expert (ring transfer p=0.00001, needle pass p=0.0004 and EA cut p=0.0014, respectively). Interrater reliability was good for ring transfer and needle pass but poor for EA cut.

the tasks distinguished between novice and intermediate/expert but not between expert and intermediate. In needle pass and EA cut, there was a trend for the experts to score higher than intermediate participants. Ring transfer and needle pass tasks achieved construct validity, had good interrater reliability and were found to be useful in assessing a novice surgeon’s progression towards the intermediate level. Distinguishing between intermediate and expert may require assessment of more complex tasks such as intracorporeal suturing and tying.

II.

II.

An appendicostomy (ACE) is a surgical option for antegrade enemas in children with severe constipation and/or fecal incontinence who have failed medical management. In 2019, we initiated an expedited post-operative protocol and sought to examine our short-term outcomes compared with our historical cohort.

A retrospective review was performed of all children undergoing ACE between 2017 and 2020. Children were excluded if they underwent an associated procedure (e.g. colon resection). Patients were divided into two cohorts historical cohort (2017-2018, Group A) and the expedited protocol (2019 to present, Group B). The primary outcome was length of stay.

30 patients met inclusion (Group A=16, Group B=14). The most common indications for ACE were constipation (50%) and constipation or fecal incontinence associated with anorectal malformation (43%). Group B experienced a decreased length of stay (1vs 3 days, P=0.001) without differences in 30-day surgical site infection (7.1% vs 18.8%, p=0.61) or unplanned visit (15.4% vs 18.8%, p=1.0). Group B had a higher prevalence of MiniACE® button placed through the appendix vs. Malone (42.8% vs 12.5%, p=0.10).

Our expedited post-op protocol decreased length of stay without other significant adverse clinical sequelae.

Retrospective Comparative Study, Level III.

Retrospective Comparative Study, Level III.

Small bowel obstructions (SBO) are one of the most common surgical emergencies, but they remain a major cause of high morbidity and mortality in patients with previous history of abdominal and pelvic surgery. Socioeconomic factors have not been extensively studied in surgical management of SBO.

We queried the 2016 NRD database for all surgically managed admissions ≥18 years of age with a primary diagnosis of SBO. The primary outcomes for this analysis were index admission mortality, 30-day mortality, and 30-day readmissions. Multivariate logistic regression models were utilized to examine the association between predictors and primary outcomes.

Medicaid patients had a higher likelihood of index admission mortality. Medicare and Medicaid patients both had higher likelihoods of 30-day readmissions.results CONCLUSIONS Careful consideration should be taken before deciding the optimal surgical approach in patients with SBO. Medicaid beneficiaries and those with existing comorbidities should receive careful post-operative follow-up to ensure optimal outcomes.

Invadopodia are actin-rich membrane protrusions that facilitate cancer cell dissemination by focusing on proteolytic activity and clearing paths for migration through physical barriers, such as basement membranes, dense extracellular matrices, and endothelial cell junctions. Invadopodium formation and activity require spatially and temporally regulated changes in actin filament organization and dynamics. About three decades of research have led to a remarkable understanding of how these changes are orchestrated by sequential recruitment and coordinated activity of different sets of actin-binding proteins. learn more In this chapter, we provide an update on the roles of the actin cytoskeleton during the main stages of invadopodium development with a particular focus on actin polymerization machineries and production of pushing forces driving extracellular matrix remodeling.The actin cytoskeleton is a dynamic network that regulates cellular behavior from development to disease. By rearranging the actin cytoskeleton, cells are capable of migrating and invading during developmental processes; however, many of these cellular properties are hijacked by cancer cells to escape primary tumors and disseminate to distant organs in the body. In this review article, we highlight recent work describing how cancer cells regulate the actin cytoskeleton to achieve efficient invasion and metastatic colonization. We also review new imaging technologies that are capable of revealing the complex architecture and regulation of the actin cytoskeleton during motility and invasion of tumor cells.