Malden Public Schools

In today’s digital age, social media plays a vital role in everyone’s life. Social media, in terms of tourism, helps travelers in finding information before, during and after their travels. The purpose of this paper is to assess the influence of social media on the travel decisions of young Lipeños in terms of information, promotion, and communication. This paper also determines what social media platform is the most influential to these Lipeños travel decisions.

Introduction Ablation of non-pulmonary vein triggers (NPVTs) after pulmonary vein isolation (PVI) reduces atrial fibrillation (AF) recurrence, but localizing NPVTs can be challenging. We evaluated the potential for noninvasive electrocardiographic imaging (ECGi) to regionalize NPVTs and expedite more focused catheter-based mapping. ECGi combines measured body surface potentials with heart-torso geometry acquired from computed tomography (CT), to generate an activation map from a single recorded beat. Methods In 12 patients with AF undergoing first time AF ablation, the ECGi vest was fitted for preprocedural CT scan and then worn during procedure. Following completion of PVI, we paced from 15 atrial sites where NPVTs commonly arise (Figure 1), and evaluated the epicardial activation map generated by ECGi during steady state pacing at cycle length of 700-800 ms allowing an unobscured P wave. Merging of invasive anatomic map with CT-based ECGi map allowed comparison of ECGi activation map with true pacing location (Figure 2). Results From 180 pacing sites in our patient cohort (67% male, 58% persistent AF, 67% left atrial dilation), median distance between earliest activation site on ECGi map and pacing location was 16 mm (interquartile range, 11-22 mm), with 95% of sites within 30 mm (Figure 2). Septal pacing sites were measured to the epicardial aspect of the interatrial septum. Conclusions ECGi is able to consistently approximate the origin of paced beats from common NPVT sites and suggests the potential for rapid regionalization of NPVTs. The identified region can then be the focus of more detailed catheter-based mapping techniques to facilitate successful ablation of NPVTs.

Start with a great quotation, and end with a great quotation. —Rod J. Rohrich, M.D. Rod J. Rohrich, M.D., sat down at the table, introduced himself with a smile and a handshake, asked a few questions, and pushed over a pen and a pad of paper. He said, “You’re trapped in an alleyway downtown late at night and some people who want to do you harm are approaching. Draw one item you would use to safely get out of that situation.” While not every one of us who ended up joining the PRS family were interviewed with that exact question (though at least three of us were), the theme and the experience of that initial interview were how we all first met Dr. Rohrich: a little daunting, enigmatic, mischievous, and challenging. When people ask us what it is like working with Dr. Rohrich, the story of our interviews certainly comes up, but that’s just one piece of fabric that makes up the quilt. Dr. Rohrich is kind and firm; passionate and protective; creative and hard-working; funny yet serious; a visionary who leads by example. He advocates for his teams, for the field of plastic surgery, and, above all, for the Plastic and Reconstructive Surgery journal itself. He has led the charge and supportively enabled his team and editorial board members to develop and launch Journal-changing, award-winning, ground-breaking initiatives. But those accomplishments have already been documented in the pages of this Journal. In this editorial, in the last issue of PRS with Dr. Rohrich as Editor-in-Chief, we aim to enter into the plastic surgery literature what it was like to work for Dr. Rohrich to make this Journal. There is no better way to do so than to share the life lessons we have learned from him along the way. Some lessons Dr. Rohrich intends to teach; others we have learned by observing his personal philosophies in practice, which if you follow him online or have spent any meaningful time with him in a professional capacity, you will note that he is more than happy to share in the form of his many pithy catchphrases and wise mottos. The first lesson, which we’ve already detailed, is that “first impressions matter.” That is true, but as Dr. Rohrich’s plethora of life lessons show, first impressions are just the beginning. “#LIVINGTHEDREAM” One of Dr. Rohrich’s most famous catchphrases and sincere lessons is to “live the dream.” For many years, he had a banner over his office door that read “#LivingTheDream”; he even spent a brief period encouraging us to “live, eat, smell, and breathe the dream!” But this isn’t just motivational small talk. Dr. Rohrich truly loves what he does—with his patients in the clinic, with his fellows, nurses, and team in the operating room, and with the editorial team on the Journal. We’ve shared many exhilarating adventures traveling to destinations around the world to meet with plastic surgeons and share the journals. It’s certainly not hard to be “living the dream” when you travel to the Taj Mahal or scale the Sydney Harbor Bridge, but it can be hard to have the same enthusiasm for daily editorial work as one does for world travel. But Dr. Rohrich does it readily and earnestly, and he wants to make sure that those in his orbit and on his teams are also “living the dream” every day. He has such enthusiasm for what he does, that it’s hard not to feel the same way. Nothing personifies this more than the “the red bag.” After years of shuttling daily paperwork from the editorial office via courier in a variety of tote bags that couldn’t hold up for long under the weight of our work, we purchased a durable big red bag embroidered with the letters “PRS” to transport the papers back and forth. The red bag showed up more and more in Dr. Rohrich’s Instagram feed, as he proudly received the bag heavily loaded with the day’s work. He asked us to feature the red bag on social media too, and we did it, solely for him at first. But Dr. Rohrich’s unbridled enthusiasm for the daily tasks of working on the Journal, personified by this bag, rubbed off on us. As The Red Bag became our office mascot, we quickly adopted this public show of enthusiasm for the hard work we did. We recorded timelapse videos of us filling it, tweeted about the joy of the daily drop off, and ritualized the end-of-day filling of it. Heck, some of us even took it home and washed it. Similarly, thanks to Dr. Rohrich’s infectious joy for life (and work) and encouragement, we all find the joy in what we do and aim to live the dream every day. Lesson learned: no matter if you’re packing your bags for global travel or your daily work, love what you do and live the dream! —Aaron Weinstein “I WISH I WORKED FOR ME” It’s a statement we’ve all heard many times from our fearless leader. Whether it was in response to one of us taking a vacation, discussion of our annual Halloween festivities, or asking him to join us out to lunch to celebrate a birthday, Dr. Rohrich would always respond, “I wish I worked for me.” It was always said in a joking manner with a smile on his face, but the truth is, you do wish you worked for Dr. Rohrich. I think all of us on the editorial team can agree, that first interview with the Editor-in-Chief, who also happens to be a world-renowned plastic surgeon, is daunting, to say the least. Those of us who weren’t warned about the brevity of said interview left Dr. Rohrich’s office replaying the 10-minute conversation and wondering if that was normal. It is, in case you were wondering. What you learn quickly, though—whether it’s through personal experience or through stories from your team—is that Dr. Rohrich is not like your “normal” boss. He has a charisma unlike any other, a drive that has you questioning how he was still awake and emailing you at 3 a.m., a comprehensive knowledge of social media to rival Gen Z, and—what most people may not see behind the scenes—a true respect, gentleness, and care for the people he works with. When one of us suffered from a deviated septum, Dr. Rohrich performed the surgery himself. When another needed a tonsillectomy, he was happy to recommend a surgeon and took time out of his busy schedule to call and check up on them a few days after the surgery. He put our safety first when COVID-19 raged out of control, supported us working from home, and helped us navigate our new normal in more ways than one. And when we had two PRS-colleague weddings in the middle of the pandemic, he was right there, sitting with the rest of us with masks on and celebrating. Dr. Rohrich is more than just a boss and fearless leader. He’s a funny, charismatic, kind, caring human being, and it’s a been a privilege to know and work with him. —Christina Carson “THE BEST OF THE BEST” “You are the Best of the Best.” These words were written on many birthday cards I—and my co-workers—have received from Dr. Rohrich over the years. These are definitely words he lived by and encouraged everyone to aspire to. Not only did he strive for excellence in his practice but with the Journal as well. He has propelled the Journal to greater things through forward thinking and innovation. When I started with the Journal, Dr. Rohrich had just officially become the Editor-in-Chief. The Journal was just switching over to the online submission system, and boy am I glad to have missed the era of snail mail and the transition to digital, but Dr. Rohrich led the painful, but necessary, charge to improve! He has consistently pushed for our PRSJournal.com website to be the best as well. Through many strategic planning meetings, I remember Dr. Rohrich always pushing our publisher to update our website with new innovative ideas to make it better, more user-friendly, and essentially “the best of the best.” Nothing less would do. With all of that labor, we have become a flagship journal for our publisher, always pushing them forward in technology and design. Though they never indicated it, they might be a little tired of hearing the words “make this better,” or “faster,” or “more accurate.” But Dr. Rohrich wouldn’t settle for anything less than the best. Dr. Rohrich’s expertise and vision lead many people to want to work with him or for him. Remembering our presence at many American Society of Plastic Surgeons annual meetings, there were so many people who would try to meet with Dr. Rohrich that we nicknamed him “the Rock Star.” I’m not sure if he can sing, but he sure can draw a crowd! His drive is one to be reckoned with. He is the only person I know who would be disappointed with an “easy” day of work. The bigger the stack of articles to go through, the happier he was. Of course, being his editorial crew, we learned from his drive for excellence and wanted to impress, so we always did our best to make sure the stack was as tall as we could make it. Dr. Rohrich’s vision and push for the Journal to be the best has led PRS to have four record-breaking impact factors in the past 5 years, tens of thousands of citations each year, the highest-quality figures and video in every article, and amazing photographs and illustrations on the cover of every issue. Working with our authors and reviewers, he strived to publish the best articles in the plastic and reconstructive surgery field. The advancement the Journal has made while he has been Editor-in-Chief has been a great accomplishment. It has been a pleasure working with “the Best of the Best,” and learning from the best how to become better at my job every day. Congratulations to Dr. Rohrich! —Angela Burch RESPECT FOR OTHER PEOPLE The first occasion on which I spent much time with Dr. Rohrich was when he and some other representatives of the editorial board, the American Society of Plastic Surgeons, and our publishing company met with Dr. Goldwyn and his staff (which consisted of myself and one other person) at the editorial office in Brookline, for a wide-ranging discussion of peer review, editorial production, the state of medicine, the state of publishing, computers, advertising, and much else; it was a very long meeting. Toward the end of the meeting, I brought up some questions about statistical methods and the correlation of texts and tables; those are not a popular topic, but Dr. Rohrich was intensely interested. No matter how tired we must have been by that time and no matter how many difficult, complicated questions had been discussed, he was fully engaged. "Ideas guy" or "nuts and bolts"? As Dr. Rohrich exemplifies, you need both. Even before he became Editor-in-Chief—in particular, while he was Co-Editor—Dr. Rohrich led the campaign for PRS to publish in full color, to appoint section editors and international editors, and to streamline in-house procedures by means of a computerized manuscript-tracking system as soon as a good system for doing that became available. He is always looking for new ideas, though he is careful about choosing and adopting them. In the philosophical tradition associated with Confucius, intellectual habits are thought of as moral habits; attention to other people's ideas and experiences is respect for other people. In this way, evidence-based medicine and caring about one's colleagues are aspects of the same basic principle. It is quite logical, therefore, that Dr. Rohrich's intellectual energy is accompanied by concern for the people he works with. Early this year, for a quite serious medical condition, I found that I was enrolled in a program that was both uncaring and incompetent. When I shared this information with Dr. Rohrich, he quickly arranged for me to become a patient of doctors at Massachusetts General Hospital, which has made a spectacular difference. Thank you, Dr. Rohrich! —Edward Tynan “CAN WE TAKE THAT AGAIN?” To prepare for each monthly 6AM “Plastic Surgery Hot Topic Videos” shoot, I would always make myself an unhealthy amount of coffee with sugar and arrive at the office, coffee in hand, to set up the cameras, lights, and microphones with Aaron. We would enjoy a few quiet moments before Dr. Rohrich walked in with a burst of energy and laughter. When he opened the door, he was already filming an Instagram post promoting the journal. As we went over what we were about to shoot and got Dr. Rohrich miked up, he would never stop engaging with us, telling us about the latest social media trends, discussing the latest goings on in the journal or the world, telling us jokes, or doing impersonations, like his classic Robin Williams. I would marvel at Dr. Rohrich’s boundless energy—and this was all before we even started recording! During the shoot, if the teleprompter accidentally projected the script backwards or upside-down, Dr. Rohrich would try his best to read it—sounding like he was speaking in tongues—and then laugh and say, “We should take that again.” If he got stuck on a tongue twister or complex phrase, he’d either chuckle and shrug it off or loudly cuss with a smile and say, “Can we take that again?” If something in the script gave him the giggles, he’d laugh—sometimes until he was red in the face—and we’d just keep rolling and laugh with him until we all caught our breath. He’d say, “Let’s take that again.” During my more-than-three-years of video shoots, Dr. Rohrich taught me an important lesson: it’s okay to laugh off a harmless mistake and try again. Watching Dr. Rohrich was watching a person who truly loves his job, truly loves what he does, and inspires everyone else to feel the same. After Dr. Rohrich left the office each time, I would get back to my full cup of coffee—which was inevitably cold by then—and I would always ask myself, “Why do I even make coffee when I have Dr. Rohrich to give me so much energy?” Thank you, Dr. Rohrich for inspiring, energizing, and challenging us to grow as professionals and people. Thank you for teaching us that it’s important to find the fun in our jobs. Thank you for being the cup of coffee that we need to get us going in the morning and throughout the day! —Madeline Ramos “YOU CAN SLEEP WHEN YOU’RE DEAD” I’ve been working with Dr. Rohrich for more than a decade. We’ve shared many meals, laughs, and experiences that will forever be etched in my memory. One that sticks out requires a bit of backstory and maybe even a bit of forgiveness. Traffic in the Dallas area is not always the easiest to navigate, and I have never required much sleep. That concoction often had me arriving first in the editorial office before the sun came up and the building was busy with activity. I typically would arrive, lock the door behind me, and work by the light of my laptop. Dr. Rohrich, being no stranger to the wee hours of the morning, decided on one particular day to also arrive at the office early. We typically didn’t cross paths in the mornings; he usually left before I arrived. But that morning, I was earlier than usual. Walking into a dark office on the phone with fresh coffee in hand, Dr. Rohrich never saw me coming. To say I scared him would be an understatement! His coffee spilled, barely missing my shoes and splattering on his shirt. I can’t write what he said, but use your imagination. Once his heart rate went down, he asked why I was there so early, and I explained, “I’m not much for sleeping.” Despite being a little soaked in coffee, he was now pleased with my surprising predawn presence. He replied with a classic line that would stick with our team for years, “You can sleep when you’re dead.” Now I’m pretty sure he was joking because I’ve seen him doze off at least once. But that saying has come to symbolize Dr. Rohrich’s energy, dedication, and work ethic, which have been a huge inspiration to me all these years. I’ve seen him come straight from a patient’s room, change into a suit, and shoot a “Plastic Surgery Hot Topic” video with no prep. I’ve seen him muscle through and aim to pronounce the names of every best-paper award winner at Plastic Surgery The Meeting because he felt each winner deserved to be recognized by name. I’ve even trailed behind him on foot as we power-walked the streets of Chicago to the restaurant rather than wait to catch an Uber. Determination flows through his veins, and the growth of PRS and PRS Global Open and resolve of his teams mirror his efforts. Thanks to Dr. Rohrich, I know that I can always catch up on my sleep another day. I must seize my waking hours to accomplish my goals. Cheers to Dr. Rohrich! Next time, the coffee is on me (not literally). —I. Donnell Moore “EVERYTHING’S GREAT!” That’s how the vast majority of my calls with Dr. Rohrich over the past 17 years have ended—a couple of quick parting words of encouragement or praise or reassurance, depending on the situation. I first met Dr. Rohrich in Chicago in 2004, while he was serving as president of American Society of Plastic Surgeons and I was in my second week as the new managing editor of Plastic Surgery News. It was a quick visit to greet the editorial team, ask about the stories we were covering, and thank us for our hard work before he was off to the next commitment. It was a quick visit, but it left us all feeling energized about the work we do. A world-renowned plastic surgeon, innovative journal editor, and a social media darling, Dr. Rohrich has many talents. It’s his uncanny ability to rally the troops, however, that may be his superpower. He’s a human exclamation point whose presence boosts levels of energy, engagement, and enthusiasm (Ramp it up!) —a coach and cheerleader rolled into one whose zest for breaking new ground is infectious. He laughs easily and praises generously but make no mistake: Dr. Rohrich is also tough, driven, and relentless in his quest for perpetual improvement. He sets a high bar for himself and those around him, but nobody works harder or has more fun while doing it. He’s always telling us that you have to love what you do, and it’s a philosophy he lives and shares every single day. Now it’s our opportunity to say, thank you, Dr. Rohrich, for all you do. Everything really has been great. —Mike Stokes “EVERYONE MAKE A TOAST!” I had only been working for PRS for a couple of months when I attended my first Plastic Surgery The Meeting, in Orlando, Florida. On our last evening, at a dinner with the editorial team, publishing staff, and various residents and editorial board members, Dr. Rohrich spoke up and said, “I want everyone to share the top three things that they’ve learned during this year’s meeting. We’ll go around the table.” I developed instant stage fright. What had I learned? It was my first meeting; where would I even begin? What if I said the wrong thing? Then I realized that I had been so caught up in the logistics of the meeting and my checklist of tasks that I hadn’t taken a moment to appreciate the things I had learned or the people I had met. This was not a quiz—Dr. Rohrich was simply encouraging us to pause and reflect while everything was still fresh, while we were still living in that moment. After this experience, I learned that any PRS function would involve sharing more than just a meal. I discovered that it was not uncommon for Dr. Rohrich to insist that we share our top goals or lessons learned after a meeting or event. At holiday luncheons, he asked us to share our resolutions for the upcoming new year. Once at a strategic planning meeting dinner, he split us into teams and challenged each team to share their best joke with the whole group. But his most frequent request is that everyone at the table make a toast (even if the only beverages on the table are glasses of water) and share straight from the heart. A traditional toast typically begins with a few words from Dr. Rohrich, and then, throughout the duration of the meal, he will call on people individually to share their own sentiments. By the end, he’s usually so excited that he can’t help but give at least one more toast himself. Over the years, I’ve grown fond of these moments because they’ve given us the opportunity to express the deep sense of pride we have in our work and the rich camaraderie we feel for each other. These toasts truly make the PRS team feel like, as Dr. Rohrich often refers to us, “the PRS family.” Dr. Rohrich is a remarkable leader because he is truly a part of the team he leads. He is as passionate about learning from others as he is about educating them, and he is as interested in the perspectives of those around him as he is in the latest surgical techniques or up-and-coming social media platforms. He inspires collaboration and growth, and he invites the professional opinions and fresh ideas of anyone willing to share. He cultivates and celebrates the shared experiences of everyone who works on the Journal, encouraging us all to learn from one another and reflect on our accomplishments together. So now I’d like to offer a toast to Dr. Rohrich himself: Cheers to the legacy you’ve built as an Editor-in-Chief, as an educator, and as an encourager. Even though your work isn’t even close to being finished, you’ve already left an indelible mark on the field of plastic and reconstructive surgery, as well as the countless people who have had the opportunity to work with you, especially those of us who are forever part of the PRS Family. —Darienne “DK” Miner “DON'T YOU KNOW WHO THAT IS?” Our individual anecdotes may not paint a complete picture, but they are representative of some of the “best of the best” lessons learned from working with Rod J. Rohrich, M.D., as the Editor-in-Chief of Plastic and Reconstructive Surgery. In conclusion, we’d like to share one more story. After a long day at the convention center at a Plastic Surgery The Meeting, in Chicago, the team went out with Dr. Rohrich, our publishers, and a few editorial board members for our annual “publisher’s dinner.” With sore feet, full stomachs, and happy hearts, we followed Dr. Rohrich out of the Uber and into the lobby of the hotel for a quick team huddle, going over the plan for the next day. Just then, the door to the bar opened into the lobby and out poured several energetic residents, for whom the night was still young. They lit up even more when they saw Dr. Rohrich and came up to him. “Dr. Rohrich! Hi! It’s nice to meet you! Can we invite you to the bar for a nightcap?” Dr. Rohrich smiled at us and turned around to shake the hands of the residents, take a selfie or two, and after a bit, he took them up on their offer. Dr. Rohrich asked the editorial team if any of us wanted to join him in the bar. Considering the time our alarms were set for the next day’s work at the meeting, we all politely declined. He said goodnight with a smile, shook hands and gave hugs, and followed the residents into the bar. One resident looked over his shoulder for a beat, baffled at what could make us miss this chance to chat with THE Rod J. Rohrich, M.D.! He said, “Why aren’t you coming? Don’t you know who that is?” We smiled knowingly at each other. We do know who Dr. Rohrich is. We feel privileged to have worked with him on PRS Global Open and PRS. We feel honored to have seen sides of him that others do not. It has been a pleasure to be his team, his colleagues, his students, and perhaps even his teachers from time to time. We have been #LivingTheDream with Dr. Rohrich, and we know the lessons learned and experiences gained will stay with us forever. To improve is to change; to be perfect is to change often. —Winston Churchill