Journal of Surgical Research最新文献

{"title":"Histological Stages of Appendicitis Associated With Imaging Characteristics: A Computed Tomography and Ultrasound-Based Comparative Study.","authors":"Luis Adrian Alvarez-Lozada, Martín Sergio Rodríguez-Garza, Francisco Javier Arrambide-Garza, Bernardo Alfonso Fernández-Reyes, Rosario Del Carmen Medellín-Vallejo, Eduardo A Rivas-Sanchez, Aldo Ramirez-Sanchez, Alejandro Quiroga-Garza, Rodrigo E Elizondo-Omaña, Oralia Barboza-Quintana","doi":"10.1016/j.jss.2026.09.021","DOIUrl":"https://doi.org/10.1016/j.jss.2026.09.021","url":null,"abstract":"<p><strong>Introduction: </strong>Appendicitis diagnosis relies heavily on medical imaging procedure studies; however, a definite diagnosis is obtained through histological assessment. Understanding the imaging characteristics and their relation to various histological phases enhance the quality of treatment recommendations. This study analyzed imaging characteristics of acute appendicitis in relation to its histological severity.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using data from a third-level hospital. Appendectomy specimens from patients with prior computed tomography (CT) scans or ultrasound (US) imaging were included. Histological stages were categorized into simple, suppurative, abscessed, and perforated phases, depending the presence of edema, vascular congestion, neutrophilic infiltrate into the muscular layer, microabscess formation, mucosal ulceration, purulent exudate, macroscopic pus, and perforation with transmural inflammation. Imaging features as fat stranding, presence of free fluid, contrast enhancement within the appendix, appendicolith detection, reactive lymph nodes in the vicinity, appendix diameter itself, increased echogenicity, and detecting heightened perfusion via Doppler imaging were compared across these stages.</p><p><strong>Results: </strong>Among 760 patients included (51.4% women, mean age 30.1 ± 5.3), 196 (25.8%) had CT scans and 361 (47.5%) had US. CT confirmed appendicitis in 59.2% of cases, yielded a negative result in 19.4%, and provided an inconclusive diagnosis in 21.4% of cases, commonly identifying fat stranding, free liquid, and contrast enhancement. US diagnosed appendicitis in 67.6% of cases, whereas 32.4% were reported as negative, with findings including increased echogenicity, Doppler perfusion, appendix identification, and free liquid in the right parietocolic gutter. All imaging characteristics were less prevalent in early stages compared to advanced stages, with a higher negativity rate in earlier stages.</p><p><strong>Conclusions: </strong>Imaging findings are associated with the histopathological severity of appendicitis. Increased histopathological severity is associated with greater frequency of CT and US findings. These relations suggest the potential for managing appendicitis based on the histological phase suspected from imaging findings. Further research is warranted.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"328 ","pages":"134-142"},"PeriodicalIF":1.6,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epithelial-Mesenchymal Transition Is Associated With Perineural Invasion in Pancreatic Ductal Adenocarcinoma.","authors":"Asama Khan, Kei Kawashima, Caleb Seavey, Elizabeth Olecki, Kazuaki Takabe, Mashaal Dhir","doi":"10.1016/j.jss.2026.09.014","DOIUrl":"https://doi.org/10.1016/j.jss.2026.09.014","url":null,"abstract":"<p><strong>Introduction: </strong>Perineural invasion (PNI) is a high-risk feature of pancreatic ductal adenocarcinoma (PDAC) and is associated with aggressive behavior and poor outcomes. The biological programs associated with PNI in PDAC remain incompletely characterized.</p><p><strong>Methods: </strong>PDAC patients in The Cancer Genome Atlas were stratified by PNI status. Gene set enrichment analysis using Hallmark gene sets was performed to characterize transcriptomic differences between PNI-positive and PNI-negative tumors. Established immune, proliferative, and genomic annotations curated from prior The Cancer Genome Atlas analyses were used for downstream comparisons.</p><p><strong>Results: </strong>A total of 101 PNI-positive and 26 PNI-negative tumors were identified. PNI was associated with higher grade (P < 0.05). Gene set enrichment analysis demonstrated enrichment of multiple gene sets in PNI-positive tumors, including pathways related to cell proliferation (G2M checkpoint, mTORC1 signaling, E2F targets, MYC targets, and mitotic spindle), immune signaling (tumor necrosis factor-α signaling via NF-κB, interferon-α, and γ responses), and epithelial-mesenchymal transition (EMT). Yet, no differences were observed in measures of tumor proliferation, aggressiveness, mutational burden, immune response, or immune cell infiltration within the tumor microenvironment. In contrast, EMT enrichment was supported by concordant biological features, including increased infiltration of mesenchymal cells and elevated expression of EMT-associated genes in PNI-positive tumors.</p><p><strong>Conclusions: </strong>PNI-positive PDAC demonstrate enrichment of EMT-related transcriptional programs with concordant microenvironmental and gene-level support.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"328 ","pages":"150-158"},"PeriodicalIF":1.6,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Colorectal Cancer Screening Gaps Among Adults Aged 45-49.","authors":"Sara Myers, Thomas Ueland, Elizabeth S Davis, Jeffrey A Franks, Jennifer S Davids, Kelly M Kenzik","doi":"10.1016/j.jss.2026.09.022","DOIUrl":"https://doi.org/10.1016/j.jss.2026.09.022","url":null,"abstract":"<p><strong>Introduction: </strong>The United States Preventative Task Force recommends initiating colorectal cancer (CRC) screening at age 45, but screening rates among 45-49 y-olds has been lower than older age groups. Reasons for low screening rates among younger individuals are not clear.</p><p><strong>Methods: </strong>Using Behavioral Risk Factor Surveillance System data from 2022 to 2024, we investigated factors associated with CRC screening among adults aged 45-49; stratified analyses were conducted among the insured and uninsured. Among screened individuals, associations with undergoing endoscopy versus another screening modality were studied. We characterized preventative care behaviors including seeking primary care, time since last checkup, and completion of other age-appropriate cancer screening.</p><p><strong>Results: </strong>Of 50,132 individuals, 21,566 (42.6%) underwent CRC screening. Those with primary care physicians had higher odds of screening (odds ratio = 1.71; 95% confidence interval = 1.47-1.98, ref: no primary care physician), but increasing time since one's last visit was associated with decreasing odds of screening at all time intervals (5+ y ago: odds ratio = 0.29; 95% confidence interval = 0.23-0.38, ref: <1 y). Lower income, rural residence, no insurance, and lower educational attainment were associated with lower odds of screening. CRC screening was completed in only 41.3% of women who had mammograms and 48% who were screened for cervical cancer.</p><p><strong>Conclusions: </strong>Uptake of CRC screening lags in adults aged 45-49, with differences in socioeconomic factors and preventative care utilization. A majority of eligible but unscreened individuals accessed other age-appropriate cancer screening tests, directing focus to patient- and provider-specific factors as potential targets for intervention.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"328 ","pages":"125-133"},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to 'A Novel Cell-Based Therapy in Segmental Bone Defect: Using Adipose Derived Stromal Cells' [Journal of Surgical Research 168 (2011) 76-81].","authors":"Jun Zou, Genlin Wang, Dechun Geng, Xuesong Zhu, Minfeng Gan, Huilin Yang","doi":"10.1016/j.jss.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.jss.2026.09.010","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed-Methods User-Centered Design Evaluation of an Electronic Patient-Reported Outcomes System to Enhance Postdischarge Care for Thoracic Surgery Patients.","authors":"Elizabeth Kwong, Meghan C O'Leary, Amanda L Gentry, Julie Johnson, Chase Cox, Lukasz Mazur, Gita N Mody","doi":"10.1016/j.jss.2026.08.002","DOIUrl":"10.1016/j.jss.2026.08.002","url":null,"abstract":"<p><strong>Introduction: </strong>Health information technology (HIT) tools intended to remotely monitor patients' symptoms using electronic patient-reported outcomes (ePROs) can improve clinical outcomes; however, successful design requires meeting the unique needs of complex end user groups. Therefore, we applied a user-centered design approach to iteratively evaluate and inform improvements to an ePRO system designed for postdischarge thoracic surgery care, incorporating perspectives of patient, caregiver, and provider end users.</p><p><strong>Methods: </strong>We purposively recruited a targeted sample of thoracic surgery patients, their caregivers, and providers to participate in field observations and semi-structured interviews; patients additionally completed the System Usability Scale and Post-Study System Usability Questionnaire to assess usability. The research team synthesized data through iterative modeling, which was subsequently validated through a mixed end user focus group. Data were analyzed using descriptive statistics and thematic content analysis guided by the Systems Approach to Health Care Delivery and Lean Six Sigma 6 Ms frameworks.</p><p><strong>Results: </strong>A total of 16 end users participated, including patients (n = 4), caregivers (n = 2), and 10 providers representing distinct segmented user groups of nurses (n = 4) and surgeons (n = 6). Emergent themes centered on user expectations, personalization, relationships, communication, and accessibility. Participants also highlighted the survey's brevity, responsiveness of the care team, opportunities to strengthen patient and provider training, the need for clearer communication regarding ePRO use, and preferences for more contextualized alerts. Findings informed specific recommendations for system optimization.</p><p><strong>Conclusions: </strong>The user-centered design approach generated rich insights into end user experiences, expectations, and interactions with the ePRO system. Future design efforts should focus on improvements that better support the diverse needs, workflows, and contexts of complex end users.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"326 ","pages":"1104-1114"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Receipt of Preventive Care and Health Promotion Counseling in Early Stage Breast Cancer Survivors.","authors":"Laura K Krecko, Jessica R Schumacher, James E Haine, Amye J Tevaarwerk, Kristine L Kwekkeboom, Trista J Stankowski-Drengler, Catherine R Breuer, Jennifer L Tucholka, Courtney Maxcy, Heather B Neuman","doi":"10.1016/j.jss.2026.08.004","DOIUrl":"10.1016/j.jss.2026.08.004","url":null,"abstract":"<p><strong>Introduction: </strong>We sought to determine the extent of receipt of preventive care and health promotion in a modern cohort of early-stage breast cancer survivors within a single breast program.</p><p><strong>Materials and methods: </strong>We enrolled patients with stage I-II ER + or PR+, HER2/neu-breast cancer diagnosed within the past 5 years from a single program (January-March 2020). Receipt of preventive care was assessed via electronic health record abstraction. Perceived receipt of health promotion counseling was evaluated via survey.</p><p><strong>Results: </strong>Our final cohort (n = 94) was mostly White females (95%) with stage I disease (73%) who were a mean of 2.5 years from diagnosis (SD = 1.3). Of 58 survivors with a primary care provider within the participating health system, the majority received preventive care services such as colorectal cancer screening (76%), pneumococcal (92%) and flu (76%) vaccinations, and mammograms (100%). Many survivors in the overall cohort did not perceive recent discussions with their healthcare providers about specific health promotion topics such as: \"How much or what kind of exercise you get\" (41%) and \"How much or what kinds of food you eat\" (18%).</p><p><strong>Conclusions: </strong>In this cohort of early-stage breast cancer survivors, documented receipt of preventive care was high (>75%). However, survivors perceived limited discussions with providers about specific health promotion topics. Our findings support the need to measure, standardize, and incentivize health promotion for breast cancer survivors to improve survivor longevity and quality of life.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"326 ","pages":"1099-1103"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting High Variable Direct Cost in Burn Care: A Comparison of Logistic and Random Forest","authors":"Tony Zhao BA, MS,&nbsp;Kaitlyn Malek BS, MS,&nbsp;Anjay Khandelwal MD, FACS, FICS, FABA","doi":"10.1016/j.jss.2026.08.039","DOIUrl":"10.1016/j.jss.2026.08.039","url":null,"abstract":"<div><h3>Introduction</h3><div>Burn care is uniquely resource-intensive, and early identification of patients at risk for high hospital-incurred costs may enable proactive care coordination and more efficient resource allocation. This study uses the actual hospital cost data, rather than indirect billing metrics, to develop early prediction models for high-cost burn admissions.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of 363 adult and pediatric burn patients admitted to a regional burn center between 2022 and 2023. High variable direct cost was defined as variable direct cost exceeding the 75th percentile of the study cohort. Two predictive models, logistic regression and Random forest, were developed using admission variables available early in the hospital course: age, total body surface area, inhalation injury, and burn mechanism. Model performance was evaluated using area under the receiver operating characteristic curve, calibration, and decision curve analysis (DCA) to assess clinical utility.</div></div><div><h3>Results</h3><div>High variable direct cost occurred in 24.8% of patients (90/363). Both models demonstrated similar discrimination (area under the receiver operating characteristic curve ≈ 0.74), with total body surface area as the most influential predictor. Logistic regression showed higher specificity (0.823) and more stable calibration, whereas the Random forest model demonstrated higher sensitivity (0.786) but greater calibration instability. On DCA, the Random forest model provided greater net benefit across clinically relevant threshold probabilities (0.05-0.25), indicating superior utility for identifying patients at risk for high costs.</div></div><div><h3>Conclusions</h3><div>Admission-based prediction models can identify high-resource burn patients early in their hospitalization. Machine learning approaches, particularly Random forest modeling, may better support prospective resource planning, though calibration limitations warrant caution before use in patient-specific decision-making. Incorporating clinical utility metrics such as DCA helps align predictive performance with real-world operational decision-making in burn care.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"326 ","pages":"Pages 1144-1152"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Regarding: Timing of Tracheostomy in Critically III Geriatric Trauma Patients: A Nationwide Analysis.","authors":"Thaddeus J Puzio, Victoria Wagner, Lilian S Kao","doi":"10.1016/j.jss.2026.05.085","DOIUrl":"10.1016/j.jss.2026.05.085","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":"1161-1162"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On The Cover","authors":"","doi":"10.1016/S0022-4804(26)00606-2","DOIUrl":"10.1016/S0022-4804(26)00606-2","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"326 ","pages":"Page xiii"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journal of Surgical Research","authors":"","doi":"10.1016/S0022-4804(26)00604-9","DOIUrl":"10.1016/S0022-4804(26)00604-9","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"326 ","pages":"Page iii"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}