Key Points
Question
How did surgical volumes change with respect to subspecialty and patient acuity during the COVID-19 pandemic, and did they recover after the peak and vaccine release periods?
Findings
In this cohort study, a retrospective analysis of 129 956 records of weekly surgical procedures from January 6, 2019, to December 31, 2021, revealed that the overall volume did not fully recover to pre–COVID-19 levels well into 2021. Recovery rates were inconsistent across surgical subspecialties and case classes.
Meaning
Further research and hospital-level changes are needed to address the backlog of surgical services and muted recovery of surgical procedures to pre–COVID-19 volumes.
Comparatively little is known about how new instrumental actions are encoded in the brain. Using whole-brain c-Fos mapping, we show that neural activity is increased in the anterior dorsolateral striatum (aDLS) of mice that successfully learn a new lever-press response to earn food rewards. Post-learning chemogenetic inhibition of aDLS disrupts consolidation of the new instrumental response. Similarly, post-learning infusion of the protein synthesis inhibitor anisomycin into the aDLS disrupts consolidation of the new response. Activity of D1 receptor-expressing medium spiny neurons (D1-MSNs) increases and D2-MSNs activity decreases in the aDLS during consolidation. Chemogenetic inhibition of D1-MSNs in aDLS disrupts the consolidation process whereas D2-MSN inhibition strengthens consolidation but blocks the expression of previously learned habit-like responses. These findings suggest that D1-MSNs in the aDLS encode new instrumental actions whereas D2-MSNs oppose this new learning and instead promote expression of habitual actions.
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