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  1. Article ; Online: Commentary on "Surgical management and outcome of grade-C pancreatic fistulas after pancreaticoduodenectomy: A retrospective multicenter cohort study".

    Molmenti, Ernesto P / Coppa, Gene F

    International journal of surgery (London, England)

    2019  Volume 70, Page(s) 11–12

    MeSH term(s) Cohort Studies ; Humans ; Pancreatectomy ; Pancreatic Fistula/surgery ; Pancreaticoduodenectomy ; Retrospective Studies
    Language English
    Publishing date 2019-08-07
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2019.08.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Transitioning trainees from the operating room to the COVID-19 intensive care unit in New York - Correspondence.

    Catalano, Michael A / Coppa, Gene F / Patel, Vihas M

    International journal of surgery (London, England)

    2021  Volume 87, Page(s) 105898

    Language English
    Publishing date 2021-02-17
    Publishing country England
    Document type Letter
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2021.105898
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  3. Article ; Online: Invited commentary: Contralateral processus closure to prevent metachronous inguinal hernia: A systematic review.

    Coppa, Gene F / Chung, Paul J

    International journal of surgery (London, England)

    2019  Volume 68, Page(s) 175

    MeSH term(s) Hernia, Inguinal/surgery ; Humans ; Laparoscopy
    Language English
    Publishing date 2019-07-21
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2019.07.014
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  4. Article ; Online: Surgical Rehabilitation for Research Residents: A Pilot Program to Offset Surgical Skill Decay.

    Nofi, Colleen P / Roberts, Bailey K / Hansen, Laura / Coppa, Gene F / Patel, Vihas

    Journal of surgical education

    2023  Volume 80, Issue 10, Page(s) 1385–1394

    Abstract: Objective: Select general surgery residents in the surgeon-scientist pipeline dedicate time away from clinical residency to conduct research. However, these research residents (RR) are vulnerable to operative skill decay. The aim of this study is to ... ...

    Abstract Objective: Select general surgery residents in the surgeon-scientist pipeline dedicate time away from clinical residency to conduct research. However, these research residents (RR) are vulnerable to operative skill decay. The aim of this study is to assess the feasibility of implementation and impact of an organized intervention designed to combat skill decay experienced by RR.
    Design: RR were enrolled in a pilot Surgical Rehabilitation Program (SRP). The SRP is comprised of 12 cadaver-based simulation sessions and supplemented with Fundamentals of Laparoscopic Surgery-based simulation workouts. The RR were integrated with the clinical residents (CR) during the cadaver sessions and were subsequently performance tested, surveyed, and interviewed.
    Setting: One academic general surgery residency program graduating 8 chief residents yearly in New York.
    Participants: General surgery CR and residents on dedicated research years.
    Results: Data were collected for all local RR (n = 8) and 77% (n = 37) of CR. Local RR conducted research within the same health system that sponsors the residency. RR experienced gaps in training ranging from 2 to 4 years. All RR were permitted to moonlight on surgical services, however performed 0 operations and only 0.88 procedures on average per shift. Although RR performed similarly to level-matched CR on basic laparoscopic tasks, they required significantly more time on laparoscopic suturing-based skills than CR (p < 0.001). RR had significantly lower confidence levels precadaver sessions but gained confidence postcadaver sessions (p < 0.05), whereas CR confidence was unchanged. Regarding the SRP, qualitative interviews revealed major themes emphasizing the integration of RR, exposure to CR and faculty, technical skill development, maintenance of surgical know-how, and improved confidence for RR.
    Conclusions: The implementation of such structured interventions, like our SRP, aimed at supporting RR over gap years is essential to help residents maintain skills and confidence needed to achieve their goals of becoming surgeon scientists.
    Language English
    Publishing date 2023-08-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2023.07.016
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  5. Article ; Online: Using Concurrent Complication Reporting to Evaluate Resident Critical Thinking and Enhance Adult Learning.

    Carsky, Katie / Rindskopf, David / Patel, Vihas M / Ansari, Parswa / Dechario, Samuel P / Giangola, Gary / Coppa, Gene F / Antonacci, Anthony C

    Journal of surgical education

    2024  Volume 81, Issue 5, Page(s) 702–712

    Abstract: Objective: Critical thinking and accurate case analysis is difficult to quantify even within the context of routine morbidity and mortality reporting. We designed and implemented a HIPAA-compliant adverse outcome reporting system that collects weekly ... ...

    Abstract Objective: Critical thinking and accurate case analysis is difficult to quantify even within the context of routine morbidity and mortality reporting. We designed and implemented a HIPAA-compliant adverse outcome reporting system that collects weekly resident assessments of clinical care across multiple domains (case summary, complications, error analysis, Clavien-Dindo Harm, cognitive bias, standard of care, and ACGME core competencies). We hypothesized that incorporation of this system into the residency program's core curriculum would allow for identification of areas of cognitive weakness or strength and provide a longitudinal evaluation of critical thinking development.
    Design: A validated, password-protected electronic platform linked to our electronic medical record was used to collect cases weekly in which surgical adverse events occurred. General surgery residents critiqued 1932 cases over a 4-year period from 3 major medical centers within our system. These data were reviewed by teaching faculty, corrected for accuracy and graded utilizing the software's critique algorithm. Grades were emailed to the residents at the time of the review, collected prospectively, stratified, and analyzed by post-graduate year (PGY). Evaluation of the resident scores for each domain and the resultant composite scores allowed for comparison of critical thinking skills across post-graduate year (PGY) over time.
    Setting: Data was collected from 3 independently ACGME-accredited surgery residency programs over 3 tertiary hospitals within our health system.
    Participants: General surgery residents in clinical PGY 1-5.
    Results: Residents scored highest in properly identifying ACGME core competencies and determining Clavien-Dindo scores (p < 0.006) with no improvement in providing accurate and concise clinical summaries. However, residents improved in recording data sufficient to identify error (p < 0.00001). A positive linear trend in median scores for all remaining domains except for cognitive bias was demonstrated (p < 0.001). Senior residents scored significantly higher than junior residents in all domains. Scores > 90% were never achieved.
    Conclusions: The use of an electronic standardized critique algorithm in the evaluation and assessment of adverse surgical case outcomes enabled the measure of residents' critical thinking skills. Feedback in the form of teaching faculty-facilitated discussion and emailed grades enhanced adult learning with a steady improvement in performance over PGY. Although residents improved with PGY, the data suggest that further improvement in all categories is possible. Implementing this standardized critique algorithm across PGY allows for evaluation of areas of individual resident weakness vs. strength, progression over time, and comparisons to peers. These data suggest that routine complication reporting may be enhanced as a critical thinking assessment tool and that improvement in critical thinking can be quantified. Incorporation of this platform into M&M conference has the potential to augment executive function and professional identity development.
    MeSH term(s) Internship and Residency/methods ; Humans ; Clinical Competence ; General Surgery/education ; Thinking ; Adult ; Education, Medical, Graduate/methods ; Male ; Female ; Curriculum ; Postoperative Complications ; Educational Measurement/methods
    Language English
    Publishing date 2024-03-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2024.02.002
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  6. Article ; Online: Laparoscopic Ventral Hernia Repair Postoperative Complications in End Stage Renal Disease Patients.

    Gurien, Steven D / Chung, Paul / Nofi, Colleen P / Coppa, Gene F / Sugiyama, Gainosuke

    JSLS : Journal of the Society of Laparoendoscopic Surgeons

    2022  Volume 26, Issue 1

    Abstract: Background: The prevalence of patients with end stage renal disease (ESRD) requiring general surgical procedures is increasing. Our aim was to explore the effect of ESRD on patients undergoing elective laparoscopic ventral hernia repair.: Methods: ... ...

    Abstract Background: The prevalence of patients with end stage renal disease (ESRD) requiring general surgical procedures is increasing. Our aim was to explore the effect of ESRD on patients undergoing elective laparoscopic ventral hernia repair.
    Methods: The American College of Surgeons National Surgical Quality Improvement Program (2010-2015) database was used to identify patients who underwent elective laparoscopic ventral hernia repair. Multivariable analysis was performed adjusting for risk variables including age, gender, race, comorbidity status, body mass index ≥ 35, and presence of ESRD.
    Results: A total of 8,789 patients undergoing elective laparoscopic ventral hernia repair were identified. Sixty-four patients (0.73%) had ESRD. ESRD was identified as an independent risk factor for postoperative pneumonia (odds ration [OR] 6.91, p = 0.00363), sepsis (OR 18.58, p = 0.000286), and length of stay (IRR 1.63, 95% confidence interval 1.19 - 2.27, p = 0.0036).
    Conclusions: ESRD patients undergoing elective laparoscopic ventral hernia repair had an increased risk of postoperative pneumonia, sepsis, and length of stay. Clinicians should be cognizant of these risks when performing elective operations on ESRD patients.
    MeSH term(s) Hernia, Ventral/surgery ; Herniorrhaphy/methods ; Humans ; Kidney Failure, Chronic/complications ; Laparoscopy/methods ; Postoperative Complications/etiology
    Language English
    Publishing date 2022-02-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2011211-7
    ISSN 1938-3797 ; 1086-8089
    ISSN (online) 1938-3797
    ISSN 1086-8089
    DOI 10.4293/JSLS.2021.00086
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  7. Article ; Online: A novel miRNA mimic attenuates organ injury after hepatic ischemia/reperfusion.

    Borjas, Timothy / Jacob, Asha / Kobritz, Molly / Patel, Vihas / Coppa, Gene F / Aziz, Monowar / Wang, Ping

    The journal of trauma and acute care surgery

    2023  Volume 94, Issue 5, Page(s) 702–709

    Abstract: Introduction: Extracellular cold-inducible RNA-binding protein (eCIRP) is a novel mediator of inflammation and tissue injury. It has been shown that miRNA 130b-3p acts as an endogenous inhibitor of eCIRP. Because RNA mimics are unstable after in vivo ... ...

    Abstract Introduction: Extracellular cold-inducible RNA-binding protein (eCIRP) is a novel mediator of inflammation and tissue injury. It has been shown that miRNA 130b-3p acts as an endogenous inhibitor of eCIRP. Because RNA mimics are unstable after in vivo administration, we have chemically engineered miRNA 130b-3p mimic (named PS-OMe miR130) to improve its stability by protection from nuclease activity. We hypothesize that PS-OMe miR130 reduces eCIRP-mediated injury and inflammation in a murine model of hepatic ischemia/reperfusion (I/R), a model of sterile inflammation.
    Methods: Adult male mice underwent 70% hepatic ischemia for 60 minutes and 24-hour reperfusion. At the start of reperfusion, mice were treated intravenously with vehicle (phosphate-buffered saline) or PS-OMe miR130. Blood and liver tissue were collected after 24 hours for biochemical analysis. Apoptosis in the liver tissue was determined by transferase dUTP nick-end labeling assay.
    Results: After hepatic I/R, organ injury markers including aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase significantly decreased after PS-OMe miR130 treatment. Furthermore, histological analysis of liver sections demonstrated significantly less injury in PS-OMe miR130 treatment mice versus vehicle mice. In addition, tumor necrosis factor α mRNA, interleukin-1β mRNA, and neutrophil infiltration (myeloperoxidase activity and granulocyte receptor 1 immunohistochemistry) were significantly attenuated after PS-OMe miR130 treatment. Finally, apoptosis significantly decreased in liver tissue after treatment.
    Conclusion: PS-OMe miR130 decreases eCIRP-mediated injury and inflammation in a murine model of hepatic I/R.
    MeSH term(s) Mice ; Male ; Animals ; MicroRNAs/metabolism ; Reperfusion Injury/metabolism ; Disease Models, Animal ; Liver Diseases/metabolism ; Liver/pathology ; Ischemia/pathology ; Reperfusion ; Apoptosis ; Inflammation/metabolism
    Chemical Substances MicroRNAs
    Language English
    Publishing date 2023-02-02
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000003877
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  8. Article ; Online: An engineered miRNA PS-OMe miR130 inhibits acute lung injury by targeting eCIRP in sepsis.

    Borjas, Timothy / Jacob, Asha / Kobritz, Molly / Ma, Gaifeng / Tan, Chuyi / Patel, Vihas / Coppa, Gene F / Aziz, Monowar / Wang, Ping

    Molecular medicine (Cambridge, Mass.)

    2023  Volume 29, Issue 1, Page(s) 21

    Abstract: Background: Sepsis is caused by the dysregulated immune response due to an initial infection and results in significant morbidity and mortality in humans. Extracellular cold inducible RNA binding protein (eCIRP) is a novel mediator identified in sepsis. ...

    Abstract Background: Sepsis is caused by the dysregulated immune response due to an initial infection and results in significant morbidity and mortality in humans. Extracellular cold inducible RNA binding protein (eCIRP) is a novel mediator identified in sepsis. We have previously discovered that microRNA 130b-3p inhibits eCIRP mediated inflammation. As RNA mimics are very unstable in vivo, we hypothesize that an engineered miRNA 130b-3p mimic named PS-OMe miR130, improves stability of the miRNA by protection from nuclease activity. We further hypothesize that PS-OMe miR130 reduces not only eCIRP-mediated inflammation and but also acute lung injury in a murine model of polymicrobial sepsis.
    Methods: Single stranded PS-OMe miR130 was synthesized and the binding affinity to eCIRP was evaluated using surface plasmon resonance (SPR) and computational modeling. Macrophages were treated with PS-OMe miR130 with and without eCIRP and cell supernatant analyzed for cytokines. In vitro stability and the in vivo half-life of PS-OMe miR130 were also assessed. The effect of PS-Ome miR130 on eCIRP's binding to TLR4 was evaluated by SPR analysis and modeling. Finally, the effect of PS-OMe miR130 on inflammation and injury was assessed in a murine model of sepsis.
    Results: We demonstrate via SPR and computational modeling that PS-OMe miR130 has a strong binding affinity to eCIRP. This engineered miRNA decreases eCIRP induced TNF-α and IL-6 proteins, and it is highly stable in vitro and has a long in vivo half-life. We further demonstrate that PS-OMe miR130 blocks eCIRP binding to its receptor TLR4. Finally, we show that PS-OMe miR130 inhibits inflammation and lung injury, and improves survival in murine sepsis.
    Conclusion: PS-OMe miR130 can be developed as a novel therapeutic by inhibiting eCIRP-mediated inflammation and acute lung injury in sepsis.
    MeSH term(s) Humans ; Animals ; Mice ; MicroRNAs/genetics ; MicroRNAs/metabolism ; Disease Models, Animal ; Toll-Like Receptor 4/metabolism ; Acute Lung Injury/etiology ; Sepsis/genetics ; Sepsis/complications ; Inflammation
    Chemical Substances MicroRNAs ; Toll-Like Receptor 4 ; MIRN130 microRNA, human ; MIRN130 microRNA, mouse
    Language English
    Publishing date 2023-02-13
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1283676-x
    ISSN 1528-3658 ; 1076-1551
    ISSN (online) 1528-3658
    ISSN 1076-1551
    DOI 10.1186/s10020-023-00607-8
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  9. Article ; Online: Recovery of Skill Decay After COVID-19 Redeployments and Implications for Competency Attainment.

    Nofi, Colleen P / Roberts, Bailey K / Demyan, Lyudmyla / Balakrishnan, Nalini / DePeralta, Danielle K / Coppa, Gene F / Patel, Vihas

    The Journal of surgical research

    2023  Volume 285, Page(s) 150–157

    Abstract: Introduction: The COVID-19 pandemic immediately interrupted procedural training. The lasting impact of reduced caseloads and service redeployments on procedural-resident training has been underexplored. This longitudinal study investigated the long-term ...

    Abstract Introduction: The COVID-19 pandemic immediately interrupted procedural training. The lasting impact of reduced caseloads and service redeployments on procedural-resident training has been underexplored. This longitudinal study investigated the long-term perspectives of skill decay after short breaks in training and implications for ensuring resident competency attainment.
    Methods: Web-based cross-sectional surveys distributed immediately after (June 2020) compared to 1 y after (July 2021) COVID-19 redeployments at two tertiary academic medical centers of an integrated health system in New York. Participants included general surgery, surgical subspecialty, and anesthesiology residents and faculty.
    Results: Fifty-five residents and 33 faculty completed the survey. Ninety-point nine percent of residents and 36.4% of faculty were redeployed to COVID-ICUs. Sixty-three-point seven percent of residents and 75.0% of faculty reported a reduction in resident technical skills in the short-term, with significantly less (45.5% of residents and 21.2% of faculty) reporting persistent reduction in technical skill after 1 y (P = 0.001, P < 0.001). Seventy-five percent of residents and 100% of faculty were confident residents would be able to practice independently at the conclusion of their training. Sixty-five-point five percent of residents and 63.6% of faculty felt that residents experienced a durable improvement in critical care skills. Residents also reported a positive long-term impact on professional core competencies at 1 y.
    Conclusions: Longitudinal surveillance of residents after COVID-19 redeployments suggests washout of temporary skill decay and return of resident confidence upon resumption of traditional training. This may provide insight into the impact of other short-term training interruptions on resident skill and promote greater resident support upon training resumption to ensure competency attainment.
    MeSH term(s) Humans ; Internship and Residency ; Longitudinal Studies ; Cross-Sectional Studies ; Pandemics ; Clinical Competence ; COVID-19 ; Faculty, Medical
    Language English
    Publishing date 2023-01-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2022.12.035
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  10. Article ; Online: Systemic Determinants in Surgery: Nonclinical Factors Affecting Time to Operation for Incarcerated Ventral Hernias.

    Wang, David E / Chung, Paul J / Barrera, Rafael / Coppa, Gene F / Alfonso, Antonio E / Sugiyama, Gainosuke

    The American surgeon

    2021  , Page(s) 31348211011118

    Abstract: Introduction: We explore nonclinical factors affecting the amount of time from admission to the operating room for patients requiring nonelective repair of ventral hernias.: Methods: Using the 2005-2012 Nationwide Inpatient Sample, we identified ... ...

    Abstract Introduction: We explore nonclinical factors affecting the amount of time from admission to the operating room for patients requiring nonelective repair of ventral hernias.
    Methods: Using the 2005-2012 Nationwide Inpatient Sample, we identified adult patients with a primary diagnosis of ventral hernia without obstruction/gangrene, who underwent nonelective repair. The outcome variable of interest was time from admission to surgery. We performed univariate and multivariable analyses using negative binomial regression, adjusting for age, sex, race, income, insurance, admission day, comorbidity status (van Walraven score), diagnosis, procedure, hospital size, location/teaching status, and region.
    Results: 7,253 patients met criteria, of which majority were women (n = 4,615) and white (n = 5,394). The majority of patients had private insurance (n = 3,015) followed by Medicare (n = 2,737). Median time to operation was 0 days. Univariate analysis comparing operation <1 day to ≥1 day identified significant differences in race, day of admission, insurance, length of stay, comorbidity status, hospital location, type, and size. Negative binomial regression showed that weekday admission (IRR 4.42,
    Conclusion: Shorter time from admission to the operating room was associated with several nonclinical factors, which suggest disparities may exist. Further prospective studies are warranted to elucidate these disparities affecting patient care.
    Language English
    Publishing date 2021-04-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/00031348211011118
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