The coronavirus 2019 (COVID-19) outbreak in March led Davidson College to move from face-to-face classes and laboratories to mostly synchronous Zoom meetings. Prior to COVID-19, the majority of our faculty and students had little experience with remote instruction. With only 5 days to develop a plan, we revisited our individual and department learning goals and worked collectively to help each other redesign and redeploy our courses. In this reflective piece, we provide examples of how each member of our department collaborated with our students to ensure a relatively smooth transition to remote teaching across our entire curriculum while maintaining inclusive excellence. Specific strategies for adapting class meetings, assignments, assessments, additional support, and labs are provided along with select examples. Common themes across the curriculum included increased flexibility, the desire to maintain community, and the need for additional academic, technical, and emotional support. We hope our reflections will be helpful to our chemistry colleagues as we move into the uncertainty of the fall semester.

Purpose:To prevent avoidable treatment and make more informed care decisions about small renal masses, the use of renal mass biopsies has increased since the early 2000s. In April 2017, Atrium Health Carolinas Medical Center began requiring biopsies before all percutaneous thermal ablation procedures for renal masses. We aim to determine the effect of this preablation biopsy mandate on small renal mass treatment decisions.Materials and Methods:Our study is a retrospective analysis of a prospectively managed database designed to track patients with small renal masses presented at the Kidney Tumor Program from 2000-2020. We separated patients into 2 cohorts (pre- and postmandate) based on the initial encounter date, excluding those from April 2017-April 2018 to allow for implementation of the mandate. We also excluded patients with masses >4 cm.Results:Overall, we found no significant difference between the pre- and postmandate cohorts, with race as an exception. Implementation of the mandate coincided with an increase in biopsies for both ablation and nonablation treatment pathways (P < .001, P = .01). Renal mass biopsy rates increased in all socioeconomic groups except the lowest quartile. Additionally, Black/Hispanic patients had the highest biopsy rate. We found significant changes in treatment decisions between our cohorts: surgery decreased 24% (P < .001), active surveillance increased 28% (P < .001), and patients with no follow-up decreased 8% (P = .03).Conclusions:Our data indicate that a preablation renal mass biopsy mandate is associated with the wider use of biopsies for all small renal mass patients, fewer surgical interventions, and an increase in active surveillance.

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Introduction: Metanephric adenomas (MAs) are clinically uncommon, with less than 200 cases previously documented. Preoperatively, MAs are difficult to diagnose due to the similarity of imaging characteristics with renal cell carcinomas. Even though MAs are benign tumors, they require careful consideration and treatment. We report a case of a MA managed via active surveillance followed by partial nephrectomy. Case Report: After presenting for abdominal pain, a 1.3 cm left renal mass was diagnosed in a 58-year-old woman. Active surveillance was initially used to manage the mass for 2 years, at which point she elected for robotic partial nephrectomy. Final histopathological diagnosis was MA. Conclusion: Preoperative diagnosis of MA is difficult as it shares many characteristic similarities with renal cell carcinomas. It is important for Urologists to be aware of MA as a diagnostic possibility. As awareness and understanding of MA increase, and diagnostic strategies continue to improve, active surveillance strategies may be increasingly utilized in management. If surgical extirpation is ultimately required, partial nephrectomy is a successful and reasonable approach