Leadership is a topic of great significance in the practice of surgery. While once acceptable for surgeons to expect control, power, and ultimate authority in their offices and operating rooms, it is now realized that a leader's strongest quality is their ability to influence circumstances in a situational fashion. A review of the definition of leadership, the qualities and styles of leaders, and opportunities for leadership development brings the principles of leadership to the forefront from which surgeons will favorably develop. These opportunities include leadership development programs during the training of surgeons to permit deliberate practice throughout their careers. The goal of these exercises is to assist individuals in converting from the prevailing or epistemological model of leadership, where one knows theories and concepts of leadership, to the emerging or ontological/phenomenological model of leadership, where one practices those theories and concepts as a consummate leader in the House of Surgery.

Normothermic regional perfusion (NRP) is a novel organ procurement strategy used for donation after circulatory death (DCD) involving in situ organ perfusion. This cross-sectional survey study assesses US public attitudes toward organ donation and willingness to donate organs after DCD-NRP, standard DCD and after brain death, comparing registered donors (registrants) and non-registered participants (non-registrants). More registrants agreed with having trust in the medical system and registrants were more likely to agree with donation in every scenario. Almost half of respondents agreed that a person must be dead to donate their vital organs. This study found that willingness to donate was associated with donor registration and trust in the medical system. A secondary finding was that there is not universal understanding of the dead donor rule and implications of first-person authorization. Overall, our findings suggest that public support for donation remains strong, and that NRP utilization does not diminish that support.

Primary aldosteronism (PA) is an under-diagnosed cause of resistant hypertension. In this study, we validated a PA risk stratification model in an independent cohort. Patients screened for PA were identified and risk scores were calculated for each patient. The predicted and observed proportions of PA-positive patients at each risk score were assessed and performance, accuracy, and cut-point analyses were calculated. Among 652 patients screened, 13% were positive for PA. Rates of PA increased significantly (p < 0.001) with increase in risk score and varied from 0% (1 point) to 29% (9 points). The optimal cut-point was 6. The model showed moderate performance at predicting the risk of PA, with AUC of 0.66 (95% CI 0.60-0.72), sensitivity of 0.57, and Brier statistic of 0.29. A novel scoring system was moderately accurate at predicting the risk of PA in an independent validation cohort and may be clinically useful in identifying patients at elevated risk.