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  • JAMA Surgery October 11, 2017

    Figure: Positive and Negative Response Word Clouds

    The size of the font is equal to the frequency of the word on the graph. The color and orientation is for effect and differentiating the words visually. There are no word lists from which the patient could choose.
  • JAMA Surgery June 1, 2017

    Figure 3: Tertiles of Resident Pretraining Individual Procedure Scores (IPSs) for 5 Trauma Core Competency Procedures With Follow-up

    The IPSs of 40 residents for each axillary artery, brachial artery, carotid artery (n = 38), and femoral artery exposure and control procedures and lower extremity fasciotomy plotted against the training interval. Color bars indicate change in performance with training of the median score for each IPS tertile at the pretraining visit. ASSET indicates Advanced Surgical Skills for Exposure in Trauma.
  • JAMA Surgery January 1, 2017

    Figure 2: Test of the Urologist-Level Correlation in the Use of Observation for Low- and High-Risk Disease

    Scatterplot shows individual urologist differences from the mean estimated probability for observation (relative to the mean) for low- and high-risk prostate cancer. The black line demonstrates the urologist-level correlation between the estimated probability of observation for low- and high-risk prostate cancer. The blue line represents the sensitivity analysis of prostate cancer experts (urologists who treated ≥10 low- and high-risk patients during the study period). For the color spectrum, green indicates ideal; red, less ideal; and yellow and orange, intermediate.
  • JAMA Surgery February 1, 2015

    Figure 1: Institutional Review Board Review Process and Overall Review Times in Calendar Days

    Rectangles indicate a process in which a particular person (or kind of person) accomplishes a task or series of tasks before the protocol advances to the next step in map; diamonds, a decision in which the actor must decide which path the protocol should follow; loops, a recursive series of processes within the overarching stream of the process. They are represented by multiple tiles superimposed and offset up and to the right. The topmost box identifies the actor who receives the protocol from the previous step and the actor who advances the protocol out of the loop to the subsequent step. The colors of the boxes identify the order of communication. Stacked rectangles indicate parallel processes that advance at the same time. Personnel are identified by the color key in the upper left hand corner that identifies the principal investigator (PI), research and development officer or committee (R&D), institutional review board (IRB) staff, IRB chair, IRB members, information security officer (ISO), privacy officer (PO), IRB committee, and associate chief of staff for research (ACOSR). Times are reported in median (range) days.
  • JAMA Surgery February 1, 2013

    Figure: Partial Recovery of Peristalsis After Myotomy for Achalasia: More the Rule Than the Exception

    Figure 1. Esophageal pressure topography studies before (left) and after (right) myotomy. A, Patient with type 2 achalasia. B, Patient with type 3 achalasia. Pressures are recorded along the esophagus from the upper esophageal sphincter (UES) to the esophagogastric junction (EGJ). Horizontal arrows represent the time elapsed. Pressure amplitudes are coded by color as scaled on the right. The patient with type 2 achalasia was characterized by impaired EGJ relaxation (mean integrated relaxation pressure [IRP], 45 mm Hg) and panesophageal pressurization. After peroral endoscopic myotomy, he had some instances of weak peristalsis characterized by proximal and distal defects in the contraction front. His postmyotomy EGJ pressure was extremely low. The patient with type 3 achalasia was characterized by impaired EGJ relaxation (mean IRP, 30 mm Hg) and premature contraction (distal latency [DL], <4.5 seconds). After myotomy, the EGJ pressure significantly decreased but premature contractions persisted (DL, <4.5 seconds).
  • Image of the Month—Diagnosis

    Abstract Full Text
    free access
    Arch Surg. 2012; 147(9):888-888. doi: 10.1001/archsurg.147.9.888
  • JAMA Surgery August 1, 2012

    Figure: Microscopic Margins and Patterns of Treatment Failure in Resected Pancreatic Adenocarcinoma

    Figure 1. Anterior view of the 4-color specimen inking of the pancreas. The neck margin is black, the portal vein groove is blue, the uncinate margin is green, and the posterior margin is yellow. The posterior pancreas is yellow (not shown).
  • Image of the Month—Diagnosis

    Abstract Full Text
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    Arch Surg. 2012; 147(7):679-680. doi: 10.1001/archsurg.147.7.679-b
  • JAMA Surgery May 1, 2012

    Figure: Surgeon Fatigue: A Prospective Analysis of the Incidence, Risk, and Intervals of Predicted Fatigue-Related Impairment in Residents

    Figure 1. Individual mental fatigue analysis with corresponding actigraphy watch data. A, The top row shows time on the x-axis and a resident's predicted fatigue level and correlated risk of medical error on the y-axis, based on the sleep, activity, fatigue, and task effectiveness (SAFTE) model at that given time. The bottom rows show daily actigraphy watch data with corresponding SAFTE predictions for a resident starting a night-float rotation over a 4-day period. The predicted fatigue levels are highlighted, while the amount of daily sleep is indicated in blue. The more active one is, the taller the bars are for that interval. As the resident converts from a standard day-shift rotation to a night-float rotation, by the fourth day, the resident becomes critically fatigued during a significant period of the work shift. B, Continuous fatigue assessment with correlated risk of medical error and the color-coded magnitude of predicted fatigue. Dark lines indicate awake periods; narrow lines indicate sleep periods. This allows for the identification of specific intervals affected by fatigue and facilitates targeted interventions. This example shows a resident on a night-float rotation and illustrates the daily fluctuation in fatigue, the influence of inadequate rest with circadian rhythm disruption, and its cumulative effect on the risk of medical error.
  • JAMA Surgery April 1, 2012

    Figure: Positive and Negative Staining of Hepatic Segments by Use of Fluorescent Imaging Techniques During Laparoscopic Hepatectomy

    Figure. Positive-staining (A) and negative-staining (B) techniques of hepatic segments using indocyanine green (ICG) fluorescent imaging during laparoscopic hepatectomy. A, Despite the thick connective tissue (due to a previous hepatectomy [right]) around the liver surface, fluorescent imaging (right) clearly delineates demarcation between segment IV (with fluorescence of ICG dye) and its surrounding nonfluorescent segments (video 1). B, Fluorescent imaging (right) clearly enables visualization of the demarcation between segment II (with portal uptake of ICG dye) and segment III (with ischemia after closure of the segmental portal branch). The normal color image shows minimal difference ([left]; video 2).
  • Image of the Month—Diagnosis

    Abstract Full Text
    free access
    Arch Surg. 2012; 147(1):96-96. doi: 10.1001/archsurg.2011.656b
  • JAMA Surgery February 1, 2010

    Figure 1Translational Research in Surgical Disease

    Patterns of RNA splice variants. Variants shown are pre–messenger RNA (exons are color coded) (A); wild-type mRNA with all exons used (B); exon skipping with second exon excluded (C); alternative 5′ splice site with only the first part of the second exon included (D); alternative 3′ splice site with only the last part of the second exon included (E); and intron retention with retention of the noncoding intron (F).
  • JAMA Surgery April 1, 2009

    Figure: Fluorescent Cholangiography Using Indocyanine Green for Laparoscopic Cholecystectomy: An Initial Experience

    Fluorescent cholangiographic images (left) and corresponding color images (right) obtained during laparoscopic cholecystectomy. A, Fluorescent cholangiography enabled the cystic duct (CyD) and the adjacent common hepatic duct (CHD) to be identified before the dissection of the trigonum cystohepaticum. The CyD was isolated (B) and clipped (C) using the fluorescent images to confirm the relationship of the CyD to the CHD.
  • JAMA Surgery May 1, 2008

    Figure 4: Functional Small-Diameter Human Tissue–Engineered Arterial Grafts in an Immunodeficient Mouse Model: Preliminary Findings

    Immunohistochemical evaluation of 8-week, 20-week, and 30-week specimens (original magnification × 400, enhanced with digital color augmentation). α–Smooth muscle actin at 8 weeks (A), 20 weeks (B), and 30 weeks (C) shows diffuse positive staining throughout the developing neomedia (arrowheads). Murine IB4 at 8 weeks (D), 20 weeks (E), and 30 weeks (F) shows a thin monolayer of murine endothelial cells (between arrowheads). von Willebrand factor at 8 weeks (G), 20 weeks (H), and 30 (I) weeks (between arrowheads).
  • JAMA Surgery May 1, 2008

    Figure 2: Functional Small-Diameter Human Tissue–Engineered Arterial Grafts in an Immunodeficient Mouse Model: Preliminary Findings

    Histological evaluation of 3-week, 8-week, and 30-week specimens (original magnification × 400, enhanced with digital color augmentation). Hematoxylin-eosin–stained specimen of 3-week (A), 8-week (B), and 30-week (C) grafts. Masson trichrome–stained specimen of 3-week (D), 8-week (E), and 30-week (F) grafts. Van Gieson–stained specimen of 3-week (G), 8-week (H), and 30-week (I) grafts. The arrowheads demarcate the thickness of the neomedial layer (ie, the layer that stains positively for α-smooth muscle actin via immunochemistry).
  • JAMA Surgery June 1, 2007

    Figure 2: Aggressive Percutaneous Mechanical Thrombectomy of Deep Venous Thrombosis: Early Clinical Results

    Duplex ultrasonography 2 weeks after percutaneous thrombectomy of the femoral vein demonstrates normal phasic flow without evidence of a thrombus. The scales represent depth of the vessel; color scale, direction of flow. CFV indicates common femoral vein.
  • JAMA Surgery March 1, 2007

    Figure 3: Laparoscopically Assisted vs Open Colectomy for Colon Cancer: A Meta-analysis

    Hazard ratios (laparoscopically assisted surgery vs open surgery) with 95% confidence intervals regarding disease-free survival (DFS) and overall survival (OS) during the first 3 years after randomization according to study and for the 4 studies combined (adjusted for sex, age, and stage). Barcelona indicates Barcelona trial; CLASICC, Conventional vs Laparoscopic-Assisted Surgery in Patients With Colorectal Cancer trial; COLOR, Colon Cancer Laparoscopic or Open Resection trial; and COST, Clinical Outcomes of Surgical Therapy trial.
  • Image of the Month—Quiz Case

    Abstract Full Text
    free access
    Arch Surg. 2006; 141(5):513-513. doi: 10.1001/archsurg.141.5.513-a
  • JAMA Surgery December 1, 2005

    Figure 2: Significance of Cellular Distribution of Ezrin in Pancreatic Cystic Neoplasms and Ductal Adenocarcinoma

    Cellular distribution of ezrin in a poorly differentiated pancreatic carcinoma cell line, PANC-1, treated using 0mM (A), 1mM (B), 3mM (C), and 5mM (D) sodium butyrate, respectively (original magnification ×400). Membranous ezrin expression (brown color) was decreased from A to D gradually.
  • Image of the Month—Quiz Case

    Abstract Full Text
    free access
    Arch Surg. 2004; 139(11):1257-1257. doi: 10.1001/archsurg.139.11.1257