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Roberto C. Heros

apple pie” to some, but may be controversial to others; still, I will go ahead and take the risk of boring many of you and irritating many others. Our American Council of Graduate Medical Education mandates that we train and objectively test our residents in six basic competencies: 1) patient care; 2) medical knowledge; 3) practice-based learning and improvement; 4) interpersonal and communication skills; 5) professionalism; and 6) system-based practice. In this talk, I will concentrate on other competencies that, though certainly overlapping with the mandated

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Sergio A. Calero-Martinez, Christian Matula, Aurelia Peraud, Francesco Biroli, José Fernández-Alén, Michael Bierschneider, Michael Cunningham, Gregory W. J. Hawryluk, Maya Babu, M. Ross Bullock and Andrés M. Rubiano

motorcyclists, and this same age range is associated with other causes of neurotrauma like armed violence by assault and gunshot injuries. 7 , 24 , 32 Recently, neurotrauma epidemiology in Western countries has changed, showing an increase in the mean age, reflected by the increase in falls among elderly patients. For the aforementioned reasons, it is imperative to improve neurosurgeons’ training during and after their medical residency with appropriate neurotrauma competencies. Unfortunately, the development of these competencies during a neurosurgeon’s career and in daily

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Natalie Limoges, Erin D’Agostino, Aaron Gelinne, Cormac O. Maher, R. Michael Scott, Gerald Grant, Mark D. Krieger, David D. Limbrick Jr., Michael White and Susan Durham

interpretation and significant individual variation. 3 Over the past decade, tools such as Milestones have been developed in an effort to standardize the education and evaluation of neurosurgical residents during their training. Implementation of an appropriate educational curriculum, whether based on case numbers, rotation duration, or objective measures of competency, requires analysis of the current exposure across a field and evaluation of what extent of exposure results in adequate training. To date, there are no published reports describing exposure to pediatric

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James K. C. Liu, Varun R. Kshettry, Pablo F. Recinos, Kambiz Kamian, Richard P. Schlenk and Edward C. Benzel

education by limiting surgical autonomy. 3 The combination of these external pressures has caused training programs to reevaluate their approach to surgical education to improve the efficiency of surgical training. One strategy is to employ more hands-on training by incorporating environments into residency training that simulate the operating room experience. To comply with the newly developed mandates on surgical education, neurosurgical training programs will likely need to develop strategies for systematically assessing a trainee’s surgical competency prior to

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Joan Margaret O’Donnell, Michael Kerin Morgan and Maurizio Manuguerra

’s license classes. 1 , 2 For those countries and states without such recommendations, most of the responsibility falls to the physician (who may recommend independent testing) and the patient. An error in judgment in declaring competence may have unanticipated ramifications. However, there are very limited data specific to driving competency following microsurgical repair of uIAs on which this decision can be confidently made. In the absence of evidence, recommendations may be inappropriate or unenforced. Therefore, improving the basis on which such recommendations can

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Katsuyuki Asaoka, Mitsuhiro Tada, Yutaka Sawamura, Jun Ikeda and Hiroshi Abe

essential. Recombinant adenovirus has been used as a competent virus vector, providing efficient gene transduction in a wide spectrum of cancers. Although several adenovirus-based experimental gene therapies have been attempted both in vitro and in vivo, 2, 10, 12, 14, 23 it has remained unclear whether an adenovirus vector is truly capable of efficiently delivering a gene into all types of gliomas. Adenoviral entry into target cells is a critical step in gene delivery. The process of adenovirus infection occurs in two serial steps: the adenovirus initially attaches to

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David J. Padalino and Eric M. Deshaies

hypodensities in the caudate nucleus, lentiform nucleus, and internal capsule, but the distal MCA territory was spared (ASPECTS 7). F ig . 4. Case 2. Postrevascularization axial MR imaging study (diffusion-weighted imaging sequence) demonstrating an acute infarction in the left basal ganglia and no large infarction of the left hemisphere seen, showing sparing of most brain tissue in the MCA and ACA distributions that had been completely occluded at presentation. Discussion Exploitation of the competent ACoAs in these 2 cases promoted rapid pharmaceutical and

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WINS White Paper Committee:, Deborah L. Benzil, Aviva Abosch, Isabelle Germano, Holly Gilmer, J. Nozipo Maraire, Karin Muraszko, Susan Pannullo, Gail Rosseau, Lauren Schwartz, Roxanne Todor, Jamie Ullman and Edie Zusman

very different mechanisms. 6 , 10 , 17 This observation suggests that a variety of learning strategies may be necessary to achieve the intended outcome of a well-trained, competent neurosurgeon. Suitable mentoring is a crucial component for all residents but may be even more important for female residents. For many women, an important component of success, particularly during residency training, is the perception of “team spirit,” with satisfaction derived as much from overall success as from individual accomplishment. 15 Obstacles to the Retention of Female

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Jeffrey J. Laurent, K. Michael Webb, Elisa J. Beres, Kevin McGee, Jinzhong Li, Bert van Rietbergen and Gregory A. Helm

concentrations of BMPs at fusion sites. Previously, we demonstrated the effectiveness of in vivo gene therapy when using direct injection of Ad-BMP-9 and Ad-BMP-2 to induce spinal fusion in athymic nude rats. 17 In these studies, percutaneous gene transfer led to significant ectopic bone formation that solidly fused multiple vertebral levels, without evidence of neural compression. In the present study we have demonstrated that a similar approach can be used in immune-competent animals and in larger animal models. Other groups have had similar success with ex vivo gene

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Christopher D. Duntsch, Qihong Zhou, Himangi R. Jayakar, James D. Weimar, Jon H. Robertson, Lawrence M. Pfeffer, Lie Wang, Zixiu Xiang and Michael A. Whitt

indicated by the red fluorescence revealed in the tissues ( Fig. 4A ). Not surprisingly, immunostaining for MAP2 on the infected slices was poor, indicating a loss of neuronal integrity ( Fig. 5A ). Thus replication-competent rVSV-wt is highly cytopathic to healthy neuronal tissue and therefore its application as a CNS oncolytic agent is neither safe nor practical without some way to protect healthy tissues from VSV-associated toxicities. Fig. 4. Photomicrographs demonstrating rVSV infection of healthy tissues and brain slice—glioma cocultures during a 3-day