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Ehyal Shweiki,1 Niels D Martin,2 Alec C Beekley,1 Jay S Jenoff,1 George J Koenig,1 Kris R Kaulback,1 Gary A Lindenbaum,1 Pankaj H Patel,1 Matthew M Rosen,1 Michael S Weinstein,1 Muhammad H Zubair,2 Murray J Cohen1 1Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA; 2Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people's choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education. Keywords: learning, education, achievement

Melissa J Cohen,1 Zev A Wainberg2,3 1Division of Hematology and Oncology, University of California Los Angeles (UCLA), Porter Ranch, 2School of Medicine, 3Gastrointestinal Oncology Program, University of California Los Angeles (UCLA), Los Angeles, CA, USA Abstract: Gastric cancer remains a lethal disease worldwide. Despite a recent increase in available systemic therapeutics, the prognosis of patients with advanced disease remains poor. A number of targeted therapies have been evaluated in gastric cancer, albeit with mixed results. Trastuzumab – the monoclonal antibody blocking HER2 – has contributed to improved survival for a minority of gastric cancer patients. Ramucirumab – a VEGF2 inhibitor – blocks the proliferation and migration of endothelial cells. The US Food and Drug Administration has recently approved ramucirumab (Cyramza) to treat patients with advanced or metastatic gastric cancer in the second-line setting following progression on fluoropyrimidine- or platinum-containing therapy. This approval was granted on the basis of the REGARD trial that demonstrated that patients treated with ramucirumab experienced a median overall survival of 5.2 months compared with 3.8 months in patients receiving placebo. Results from the RAINBOW randomized Phase III clinical trial have also shown improvements in overall survival for ramucirumab plus paclitaxel versus paclitaxel alone in patients previously treated for locally advanced or metastatic gastric cancer. In both studies, the most common adverse events reported were hypertension, diarrhea, and fatigue. Because of the encouraging advancement in novel targeted therapies, the future is looking brighter for patients with advanced gastric cancer. While this research is promising, further evaluation and identification of targets or population subsets that can be identified prospectively will likely help predict who will benefit most from these therapies. Keywords: metastatic gastric cancer, ramucirumab, targeted therapies, angiogenesis, Cyramza

Spinal cord injury (SCI) is a devastating event with a limited hope for recovery and represents an enormous public health issue. It is crucial to understand the disturbances in the metabolic network after SCI to identify injury mechanisms and opportunities