Increasing Applicant Engagement During the 2020-2021 Virtual Residency Interview Cycle and Beyond: The Dartmouth-Hitchcock Radiology Residency Video Project.

RATIONALE AND OBJECTIVES: To explore the effectiveness of the video medium and YouTube platform in conveying residency program and community information to prospective applicants during the 2020-2021 virtual residency interview cycle. To garner insights on the virtual-only residency interview experience and our video-centered approach through survey data collected from interviewing candidates for potential implementation in future application cycles. MATERIALS AND METHODS: 13 custom content videos were produced highlighting our radiology residency program and uploaded onto a newly created YouTube channel and the institutional website during the late summer through fall of the 2020-2021 residency interview cycle. Feedback on the videos was generated using YouTube analytics and an anonymous 10-question survey sent to interviewing candidates. RESULTS: As of September 29, 2021, the date when residency programs could begin reviewing ERAS applications for the 2021-2022 cycle, the videos amassed 4487 views with over 149 hours' worth of material viewed. 57 of 114 interviewed candidates responded to the survey. Feedback was overwhelmingly positive with 84% of respondents agreeing that the videos positively influenced their decision to apply to our program, 77% of respondents judging our video-based format to be overall more effective in delivering residency program information than text-based media (website, email etc.), and 86% feeling adequately informed about the program through the virtual interview process and provided electronic resources. 79% of respondents felt our videos to be more informative than the resources from other radiology programs encountered during the interviewing cycle. Finally, a majority 72% of respondents are open to virtual interviewing in the future. CONCLUSIONS: Our program's video-centered approach was one of many creative media solutions employed by residency programs across the nation to help make virtual interviewing an adequate replacement to the traditional in-person interviewing experience. While further investigation is needed to determine which methods communicate residency program information best in the virtual setting, our initial experience and data show the video-centered approach to be overwhelmingly positive with applicants and at a minimum, we've established a baseline process and aesthetic for others to improve upon.

Fine Needle Aspiration Cytology of Malignant Digestive System Gastrointestinal Neuroectodermal Tumor in a Lymph Node Metastasis from a Previously Diagnosed Liver Primary: A Case Report and Review of Literature.

Malignant gastrointestinal neuroectodermal tumor (GNET) is an extremely rare neoplasm. Immunohistochemically, GNET typically demonstrates neural differentiation but lacks melanocytic differentiation, making it distinct from clear cell sarcoma of the soft tissues (CCS). Herein we report for the first time the cytomorphologic features of lymph node metastasis from presumably liver GNET. A 36-year-old female presented with fevers, night sweats, loss of appetite, and a 20-lbs weight loss. Radiographic imaging showed a 13 cm heterogeneously enhancing mass in the right lobe of the liver and a hypermetabolic 0.9 cm periportal lymph node on positron emission tomography-computed tomography (PET/CT). Initially, a CT-guided liver biopsy was performed followed by right hepatic lobectomy and portal lymphadenectomy. The liver biopsy and resection showed an S100-protein and SOX10 positive malignant neoplasm and genomic profiling of liver biopsy revealed EWSR1-CREB1gene rearrangement. These findings in conjunction with the morphologic and immunohistochemical profile were diagnostic of GNET. Two months later, she presented with recurrent lymphadenopathy in the upper abdomen. Fine needle aspiration of the periportal nodal mass revealed single and clusters of primitive, large to medium-sized neoplastic cells with round to oval nuclei, high nuclear-cytoplasmic ratio, vesicular chromatin, and prominent nucleoli. The tumor cells were S100 protein and SOX10 positive, consistent with metastasis of the patient's recently diagnosed malignant digestive system GNET. Palliative chemotherapy was administered but the patient died a few days later, 4 months from the initial diagnosis. Awareness of this entity and judicial use of ancillary studies including molecular testing are essential for achieving accurate diagnosis.

Risk factors for stent graft thrombosis after transjugular intrahepatic portosystemic shunt creation.

BACKGROUND: To identify risk factors of stent graft thrombosis after transjugular intrahepatic portosystemic shunt (TIPS) creation. METHODS: Patients who underwent TIPS creation between June 2003 and January 2016 and with follow-up assessing stent graft patency were included (n=174). Baseline comorbidities, liver function, procedural details and follow-up liver function tests were analyzed in association with hazards of thrombosis on follow-up. Competing risk cox regression models were used considering liver transplant after TIPS creation as the competing risk variable. RESULTS: One-, 2- and 5-year primary patency rates were 94.1%, 91.7% and 78.2%, respectively. Patient age [sub-hazard ratio (sHR): 1.13; P=0.001], body mass index (BMI) <30 (sHR: 33.08; P=0.008) and a higher post-TIPS portosystemic pressure gradient (sHR: 1.14; P=0.023) were significantly associated with TIPS thrombosis in multivariate analysis. A higher rate of TIPS thrombosis was observed in those for whom the procedure was clinically unsuccessful (P=0.014). A significant increase in incidence of thrombosis was noted with increasing tertiles of post-TIPS portosystemic gradients (P value for trend=0.017). CONCLUSIONS: Older age, lower BMI and higher post-TIPS portosystemic gradients were associated with higher hazards of shunt thrombosis after TIPS creation using stent grafts. Higher rates of shunt thrombosis were seen in patients for whom TIPS creation was clinically unsuccessful. The association between TIPS thrombosis and higher post-TIPS portosystemic gradients may indicate impaired flow through the shunt, a finding which may be technical or anatomic in nature and should be assessed before procedure completion.