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Background: In Canada, residency programs do not have many objective measures for ranking candidates. Instead, ranking relies on subjective measures such as letters of reference, which can be affected by the genders of the writer and the applicant. Our study assesses letters of recommendation for a general surgery program in Canada to categorize differences in reference letters based on the genders of applicant and letter writer. Methods: We assessed 215 reference letters from 51 general surgery candidates for systematic differences in the descriptors used for male and female applicants and differences based on male and female authorship. Results: Female applicants were more often described as mature, pleasant and flexible. Male applicants were more often described as having initiative, completing research, earning awards and performing extracurricular activities. Female writers were more likely to highlight an applicant's interest, initiative, response to feedback, knowledge of their limits, flexibility, communication, achievement in research and awards, confidence and ability to be a good assistant. Significantly more female applicants had female letter writers, compared with male applicants. Conclusion: These differences may affect the acceptance of applicants based on their gender and the genders of people who recommend them. Future research is required to explore how these differences in how applicants are described may affect residency selection committees' perceptions and rankings of applicants. Contexte : Au Canada, les programmes de residence n'offrent pas beaucoup de mesures objectives pour classer les candidatures. Le classement repose plutdt sur des mesures subjectives, comme les lettres de recommandation, qui pourraient etre influencees par le sexe des personnes qui posent leur candidature et qui redigent les lettres. Notre etude porte sur des lettres de recommandation en vue de l'admission a un programme de chirurgie generale au Canada et vise a categoriser les differences selon le sexe des personnes qui posent leur candidature et qui redigent les lettres. Methodes : Nous avons evalue 215 lettres de recommandation concernant 51 candidatures en chirurgie generale afin de determiner les differences systematiques dans les qualificatifs utilises pour les candidats et les candidates, et les differences fondees sur le sexe des personnes ayant redige les lettres. Resultats : Les candidates etaient plus souvent decrites comme etant matures, agreables et flexibles. Les candidats etaient plus souvent decrits comme faisant preuve d'initiative, menant a bien des recherches, obtenant des prix et participant a des activites parascolaires. Les redactrices etaient plus susceptibles de souligner l'interet, l'esprit d'initiative, la reaction aux commentaires, la conscience de ses pro-pres limites, la flexibilite, la communication, les realisations en matiere de recherche et l'obtention de prix, la confiance et l'aptitude a agir en << bon assistant >>. Les lettres etaient redigees par des femmes pour un nombre considerablement plus eleve de candidates que de candidats. Conclusion : Ces differences pourraient influer sur l'admission des personnes qui posent leur candidature selon leur sexe et celui des personnes qui redigent les lettres. D'autres recherches seraient necessaires pour explorer comment les differences dans la description des personnes peuvent influer sur les perceptions et le classement des candidatures par les comites de selection des programmes de residence., Various aspects of residency program applications have been shown to be affected by the genders of both applicants and writers of recommendation letters. There is growing concern in the surgical [...]

Heme oxygenase (HO) represents the rate-limiting enzyme in the degradation of heine into carbon monoxide (CO), iron, and biliverdin. Recent evidence suggests that several of the beneficial properties of HO, may be linked to CO. The objectives of this study were to determine if low-dose inhaled CO reduces remote intestinal leukocyte recruitment, proinflammatory cytokine expression, and oxidative stress elicited by hindlimb ischemia-reperfusion (I/R). Male mice underwent 1 h of hindlimb ischemia, followed by 3 h of reperfusion. Throughout reperfusion, mice were exposed to AIR or AIR + CO (250 ppm). Following reperfusion, the distal ileum was exteriorized to assess the intestinal inflammatory response by quantifying leukocyte rolling and adhesion in submucosal postcapillary venules with the use of intravital microscopy. Ileum samples were also analyzed for proinflammatory cytokine expression [tumor necrosis factor (TNF)-[alpha] and interleukin (IL)-l[beta] and malondialdehyde (MDA) with the use of enzyme-linked immunosorbent assay and thiobarbituric acid reactive substances assays, respectively. I/R + AIR led to a significant decrease in leukocyte rolling velocity and a sevenfold increase in leukocyte adhesion. This was also accompanied by a significant 1.3-fold increase in ileum MDA and 2.3-fold increase in TNF-[alpha] expression. Treatment with AIR + CO led to a significant reduction in leukocyte recruitment and TNF-[alpha] expression elicited by I/R; however, MDA levels remained unchanged. Our data suggest that low-dose inhaled CO selectively attenuates the remote intestinal inflammatory response elicited by hindlimb I/R, yet does not provide protection against intestinal lipid peroxidation. CO may represent a novel anti-inflammatory therapeutic treatment to target remote organs following acute trauma and/or I/R injury. carbon monoxide; inflammation; ischemia-reperfusion; systemic inflammatory response syndrome

Heme oxygenase (HO) represents the rate-limiting enzyme in the degradation of heme into, carbon monoxide (CO), iron, and biliverdin. Recent evidence suggests that several of the beneficial properties of HO, may be linked to CO. The objectives of this study were to determine if low-dose inhaled CO reduces remote intestinal leukocyte recruitment, proinflammatory cytokine expression, and oxidative stress elicited by hindlimb ischemia- reperfusion (l/R). Male mice underwent 1 h of hindlimb ischemia, followed by 3 h of reperfusion. Throughout reperfusion, mice were exposed to AIR or AIR + CO (250 ppm). Following reperfusion, the distal ileum was exteriorized to assess the intestinal inflammatory response by quantifying leukocyte rolling and adhesion in submucosal postcapillary venules with the use of intravital microscopy. Ileum samples were also analyzed for proinflammatory cytokine expression [tumor necrosis factor (TNF)-α and interleukin (IL)- 1β] and malondialdehyde (MDA) with the use of enzyme-linked immunosorbent assay and thiobarbituric acid reactive substances assays, respectively. I/R + AIR led to a significant decrease in leukocyte rolling velocity and a sevenfold increase in leukocyte adhesion. This was also accompanied by a significant 1.3-fold increase in ileum MDA and 2.3-fold increase in TNF-α expression. Treatment with AIR + CO led to a significant reduction in leukocyte recruitment and TNF-α expression elicited by l/R; however, MDA levels remained unchanged. Our data suggest that low-close inhaled CO selectively attenuates the remote intestinal inflammatory response elicited by hindlimb I/R, yet does not provide protection against intestinal lipid peroxidation. CO may represent a novel anti-inflammatory therapeutic treatment to target remote organs following acute trauma and/or I/R injury. [ABSTRACT FROM AUTHOR]

Presents a study that used inhaled carbon monoxide at low concentration to determine whether remote benefits could be realized within the liver in the setting of systemic inflammatory response and to test the role of carbon monoxide as the mechanism of heme oxygenase-derived protection. Principal findings; Conclusions and significance.