Alcohol Use and the Risk of Colorectal Liver Metastasis: A Systematic Mapping Review.

The consumption of alcohol has long been associated with the development of liver disease as well as cancers including colorectal cancer (CRC). Leading healthcare concerns include the prevalent use of alcohol and the high burden of CRC mortality. Many CRC deaths are attributed to the development of colorectal liver metastasis (CRLM) as the liver is the foremost site of CRC spread. However, an association has not been defined for the role of alcohol intake and related liver injury with the development of CRLM. Here, a mapping review of recent research was undertaken to evaluate the relationship between alcohol consumption and the risk of CRLM. The literature search revealed 14 articles meeting the inclusion criteria that included patient database analyses and preclinical studies. Most of the human data analyses found alcohol use independently associates with worse CRC outcomes. The preclinical evaluations identified several pathways involved in the alcohol-mediated promotion of CRLM burden and CRC cell metastatic behavior. The limited number of studies identified exposes a significant need for more prospective analyses to define the role of alcohol intake and advanced CRC as well as the translation of preclinical research to fully characterize targetable mechanisms for the generation of new therapeutic options.

Interventions Associated With Racial and Ethnic Diversity in US Graduate Medical Education: A Scoping Review.

Importance: Racially and ethnically minoritized individuals remain underrepresented in graduate medical education relative to their proportion in the population. While many programs and initiatives have been developed to address this problem, there is little consensus regarding strategies that work to improve representation across specialties. Objective: To examine and synthesize evidence-based practices that have been used to increase the proportions of underrepresented in medicine (URiM) trainees at US residency and fellowship programs. Evidence Review: The authors searched PubMed, Google Scholar, Embase, PsycInfo, ERIC, Cochrane Reviews, Cochrane Trials, CINAHL, Scopus, and PROSPERO electronic databases to identify relevant studies published through January 2022. They screened all titles and abstracts for relevance and read full-text articles to identify articles reporting reliable data describing the outcomes of interventions to improve racial and ethnic diversity among trainees. Findings: Twenty-seven articles were included in this review. Two studies reported on fellowship programs. The most common interventions included holistic review (48%), decreased emphasis on United States Medical Licensing Examination Step 1 scores (48%), and explicit institutional messaging regarding the importance of diversity (37%). A combination of interventions was associated with an increased number of URiM applicants, interviewees, and matriculants across various medical and surgical specialties. Conclusions and Relevance: In this scoping review, approaches and interventions associated with increased diversity in residency and fellowship programs were identified. Continued efforts are necessary to sustain such efforts and assess long-term outcomes.

Soft Tissue Dermal Filler-Associated Necrosis and Impending Necrosis: A Systematic Review of the Literature.

BACKGROUND: Cosmetic soft tissue fillers are a popular minimally invasive procedure. Necrosis is a rare yet devastating complication of soft tissue fillers. To date, the relationship between soft tissue fillers and necrosis has not been fully described. OBJECTIVE: To systematically compile published cases of soft tissue fillers resulting in necrosis and collect data regarding the injection, treatment, and outcome. METHODS AND MATERIALS: Using PRISMA protocol, a comprehensive search for soft tissue filler necrosis was performed using no time constraints, resulting in 97 articles encompassing 192 cases of soft tissue filler necrosis containing individual-level data. RESULTS: Of the cases analyzed, 66.1% had progressed to necrosis, whereas 33.9% of patients had impending necrosis. Necrosis most commonly resulted from injection of the nasolabial fold (32.4%, n = 88). The filler material most commonly used was hyaluronic acid (71.9%, n = 138). Hyaluronidase was used most frequently as an initial treatment agent (19.1%, n = 88). Forty-three patients (22.4%) with necrosis had a prior minor procedure or surgery. CONCLUSION: This systematic review is an extensive overview of necrosis as a complication of soft tissue fillers. It serves as a reference tool for any clinician who injects soft tissue fillers and any provider who encounters soft tissue filler necrosis.

MLA Colleague Connection: a transition to a virtual mentoring program.

Background: Since 2003, the MLA Membership Committee has facilitated an in-person mentoring program called Colleague Connection at the annual meeting. The program hinged on meeting attendance, so members who could not attend were excluded. The 2020 virtual meeting created an opportunity to rethink the Colleague Connection experience. Three members of the Membership Committee developed an expanded and virtual version of the mentoring program. Case Presentation: Colleague Connection was promoted via the MLA '20 vConference Welcome Event, MLAConnect, and email lists. The 134 participants were matched based on same-chapter preference, library type, practice area interest, and years of experience. Mentees chose mentor-mentee or peer pairs, resulting in 4 peer matchings and 65 mentor-mentee matchings. Pairs were encouraged to meet monthly, and conversation prompts were provided. A Wrap-Up Event was held for participants to talk about their experiences and network. A survey evaluated the program and sought suggestions for improvement. Conclusion: The online format boosted participation, and the format change was well received. In the future, a formal orientation meeting and communication plan can ensure pairs make their initial connections and provide clarity about program details, expectations, timelines, and contact information. The type of pairings and size of the program are important considerations for the feasibility and sustainability of a virtual mentoring program.