bluuebunny/crossref_metadata_2025 huggingface dataset:
Trajectories of satisfaction with work–family reconciliation among midlife employees: the role of family-related factors and quality of life
Authors: Neupane Subas , Lallukka Tea , Salonsalmi Aino , Haukka Eija , Leino-Arjas Päivi
Published: July 2024

We studied the developmental trajectories of satisfaction with work–family reconciliation (WFS) and their associations with family—related factors and quality of life measures among municipal employees. The study was based on the Helsinki Health Study of municipal employees of the City of Helsinki in 2001–02 and its follow-up surveys in 2007, 2012, and 2017. Employees aged 40–50 at baseline and working at all timepoints were analysed (n = 1681, 84% women). Growth Mixture Models were applied to identify trajectories of WFS (dissatisfied vs. satisfied). Associations of family-related and quality-of-life factors (physical functioning and emotional well-being) with the WFS trajectories were studied using log-binomial regression models, adjusting for sociodemographic and lifestyle variables. Two WFS trajectories, low (women 45%; men 53%) and high were identified. In a fully adjusted model among women, having ≥1 children aged 0–6 years was associated with increased odds of belonging to the low WFS trajectory (OR 1.52, 95% CI 1.19–1.95). Among men, having ≥1 children aged 7–18 was associated with decreased odds (0.39, 0.19–0.80). High emotional well-being was inversely associated with the low WFS trajectory among both genders (women 0.32, 0.23–0.45; men 0.20, 0.09-0.46). High physical functioning (0.59, 0.42–0.83) was inversely associated with the low WFS trajectory among women only. Less than half of the women and more than half of the men participants belonged to a low WFS trajectory, which associated with the age of children in the family and quality-of-life measures.
Understanding the genetic basis of blueberry postharvest traits to define better breeding strategies
Authors: Casorzo Gonzalo , Ferrão Luis Felipe , Adunola Paul , Tavares Flores Estefania , Azevedo Camila , Amadeu Rodrigo , Munoz Patricio R
Published: July 2024

Blueberry (Vaccinium spp.) is among the most-consumed soft fruit and has been recognized as an important source of health-promoting compounds. Highly perishable and susceptible to rapid spoilage due to fruit softening and decay during postharvest storage, modern breeding programs are looking to maximize the quality and extend the market life of fresh blueberries. However, it is uncertain how genetically controlled postharvest quality traits are in blueberries. This study aimed to investigate the prediction ability and the genetic basis of the main fruit quality traits affected during blueberry postharvest to create breeding strategies for developing cultivars with an extended shelf life. To achieve this goal, we carried out target genotyping in a breeding population of 588 individuals and evaluated several fruit quality traits after 1 day, 1 week, 3 weeks, and 7 weeks of postharvest storage at 1°C. Using longitudinal genome-based methods, we estimated genetic parameters and predicted unobserved phenotypes. Our results showed large diversity, moderate heritability, and consistent predictive accuracies along the postharvest storage for most of the traits. Regarding the fruit quality, firmness showed the largest variation during postharvest storage, with a surprising number of genotypes maintaining or increasing their firmness, even after 7 weeks of cold storage. Our results suggest that we can effectively improve the blueberry postharvest quality through breeding and use genomic prediction to maximize the genetic gains in the long term. We also emphasize the potential of using longitudinal genomic prediction models to predict the fruit quality at extended postharvest periods by integrating known phenotypic data from harvest.
Improvement of Immune Function and Redox State in Several Organs of Old and Prematurely Aging Female Mice After a Short Social Interaction With Adults
Authors: Félix Judith , Díaz-Del Cerro Estefanía , De la Fuente Mónica
Published: July 2024

Aging is associated with chronic oxidative stress, which contributes to the deterioration of the immune system, increasing morbidity and mortality. A positive social environment permits health maintenance and a slower rate of aging. Improvements in immune function and oxidative stress were shown in peritoneal leukocytes and organs of old mice and adult prematurely aging mice (PAM) after cohabitation with adults or exceptional non-prematurely aging mice (ENPAM), respectively, for 2 months, but adults and ENPAM experienced deterioration. This was solved by shortening the cohabitation time to 15 minutes per day for 2 months, where old mice and PAM maintained immune and redox state improvements in their peritoneal leukocytes, as well as a greater longevity, and adults and ENPAM did not show deterioration. However, it is unknown whether the positive effects of this short cohabitation are reflected in the immunity and redox state of the organs. The aim of the present study was to test whether a cohabitation of 15 minutes per day for 2 months maintains these positive effects in the organs of retired breeder female old mice and PAM and avoids the negative ones in adults and ENPAM. After cohabitation the animals were sacrificed, and the thymus and spleen were extracted to evaluate the immune function. The oxidative state was also analyzed in the spleen, liver, heart, lung, and kidney. The results show that after cohabitation, old mice and PAM improved their immunity and redox state, and adults and ENPAM showed no deterioration. This cohabitation can be suggested to improve health and slow down aging.
Impact of Frailty, Early Vascular Decline, and Subclinical Cognitive Impairment in Midlife Adults: Study Protocol of the Toledo Study for Healthy Ageing in Middle Age
Authors: Alcazar Julian , Muñoz-Muñoz Miguel , Baltasar-Fernández Iván , Leal-Martín Javier , García-Aguirre Mikel , Sánchez-Martín Coral , Gutiérrez-Reguero Héctor , Sierra-Ramon Miguel , Alfaro-Acha Ana , Losa-Reyna José , Alegre Luis M , Ara Ignacio , García-García Francisco José
Published: July 2024

Life expectancy has increased worldwide alongside a rise in disability prevalence during old age. The impact and interrelationship among the precursors of disability in midlife remain to be better understood. Furthermore, investigating whether lifestyle factors may potentially influence health outcomes and the prognosis of vascular disease could be especially relevant among the middle-aged population, which is a priority subpopulation when prevention is the goal. This is an observational, cross-sectional, and population-based study. Participants, between 50 and 55 years old, are randomly selected from the municipality of Toledo (Spain). There are 6 nonconsecutive days for the assessments, providing enough rest between evaluations. Participants perform the interview of the Toledo Study for Healthy Aging. Blood pressure monitoring and a resting electrocardiogram are also recorded. Then, resting peripheral and cerebral vascular measurements along with muscle size and architecture are assessed. Blood and urine samples and body composition data are collected after an overnight fasting. On a different visit, physical performance and muscle function tests are performed. Additionally, brain magnetic resonance imaging is conducted. And finally, an accelerometer is given to the participants for a week. Frailty is evaluated by the Frailty Trait Scale and Fried Frailty Phenotype. This project will shed light on the associations between frailty, early cognitive impairment, and vascular aging during midlife, and on the role that lifestyles play in their development. Lastly, this project will provide meaningful implications for public health strategies aimed at promoting healthy aging in later life.
ChatGPT’s Role in Gerontology Research
Authors: Kaufmann Christopher N , Bai Chen , Borgia Brianne , Leeuwenburgh Christiaan , Lin Yi , Mardini Mamoun T , McElroy Taylor , Swanson Clayton W , Wimberly Keon D , Zapata Ruben , Zeidan Rola S , Manini Todd M
Published: July 2024

Background

Chat Generative Pre-trained Transformer (ChatGPT) and other ChatBots have emerged as tools for interacting with information in manners resembling natural human speech. Consequently, the technology is used across various disciplines, including business, education, and even in biomedical sciences. There is a need to better understand how ChatGPT can be used to advance gerontology research. Therefore, we evaluated ChatGPT responses to questions on specific topics in gerontology research, and brainstormed recommendations for its use in the field.

Methods

We conducted semistructured brainstorming sessions to identify uses of ChatGPT in gerontology research. We divided a team of multidisciplinary researchers into 4 topical groups: (a) gero-clinical science, (b) basic geroscience, (c) informatics as it relates to electronic health records, and (d) gero-technology. Each group prompted ChatGPT on a theory-, methods-, and interpretation-based question and rated responses for accuracy and completeness based on standardized scales.

Results

ChatGPT responses were rated by all groups as generally accurate. However, the completeness of responses was rated lower, except by members of the informatics group, who rated responses as highly comprehensive.

Conclusions

ChatGPT accurately depicts some major concepts in gerontological research. However, researchers have an important role in critically appraising the completeness of its responses. Having a single generalized resource like ChatGPT may help summarize the preponderance of evidence in the field to identify gaps in knowledge and promote cross-disciplinary collaboration.
Impairment of Renal and Hematopoietic Stem/Progenitor Cell Compartments in Frailty Syndrome: Link With Oxidative Stress, Plasma Cytokine Profiles, and Nuclear DNA Damage
Authors: Bombelli Silvia , Grasselli Chiara , Mazzola Paolo , Veronesi Valentina , Morabito Ivana , Zucchini Nicola , Scollo Chiara M , Blanco Salvatore I , De Marco Sofia , Torsello Barbara , Vitarelli Federica , Antolini Laura , Bianchi Cristina , Leoni Valerio , Bellelli Giuseppe , Perego Roberto A
Published: July 2024

Frailty is an age-related syndrome that drives multiple physiological system impairments in some older adults, and its pathophysiological mechanisms remain unclear. We evaluated whether frailty-related biological processes could impair stem cell compartments, specifically the renal stem compartment, given that kidney dysfunctions are frequent in frailty. A well-characterized in vitro nephrosphere model of human adult renal stem/progenitor cells has been instrumental to and was appropriate for verifying this hypothesis in our current research. Evaluating the effects of plasma from older individuals with frailty (frail plasma) on allogeneic renal stem/progenitor cells, we showed significant functional impairment and nuclear DNA damage in the treated cells of the renal stem compartment. The analysis of the frail plasma revealed mitochondrial functional impairment associated with the activation of oxidative stress and a unique inflammatory mediator profile in frail individuals. In addition, the plasma of frail subjects also contained the highest percentage of DNA-damaged autologous circulating hematopoietic progenitor/stem cells. The integration of both molecular and functional data obtained allowed us to discern patterns associated with frailty status, irrespective of the comorbidities present in the frail individuals. The data obtained converged toward biological conditions that in frailty caused renal and hematopoietic impairment of stem cells, highlighting the possibility of concomitant exhaustion of several stem compartments.
Integration of CTCF loops, methylome, and transcriptome in differentiating LUHMES as a model for imprinting dynamics of the 15q11-q13 locus in human neurons
Authors: Gutierrez Fugón Orangel J , Sharifi Osman , Heath Nicholas , Soto Daniela C , Gomez J Antonio , Yasui Dag H , Mendiola Aron Judd P , O’Geen Henriette , Beitnere Ulrika , Tomkova Marketa , Haghani Viktoria , Dillon Greg , Segal David J , LaSalle Janine M
Published: July 2024

Human cell line models, including the neuronal precursor line LUHMES, are important for investigating developmental transcriptional dynamics within imprinted regions, particularly the 15q11-q13 Angelman (AS) and Prader-Willi (PWS) syndrome locus. AS results from loss of maternal UBE3A in neurons, where the paternal allele is silenced by a convergent antisense transcript UBE3A-ATS, a lncRNA that terminates at PWAR1 in non-neurons. qRT-PCR analysis confirmed the exclusive and progressive increase in UBE3A-ATS in differentiating LUHMES neurons, validating their use for studying UBE3A silencing. Genome-wide transcriptome analyses revealed changes to 11 834 genes during neuronal differentiation, including the upregulation of most genes within the 15q11-q13 locus. To identify dynamic changes in chromatin loops linked to transcriptional activity, we performed a HiChIP validated by 4C, which identified two neuron-specific CTCF loops between MAGEL2-SNRPN and PWAR1-UBE3A. To determine if allele-specific differentially methylated regions (DMR) may be associated with CTCF loop anchors, whole genome long-read nanopore sequencing was performed. We identified a paternally hypomethylated DMR near the SNRPN upstream loop anchor exclusive to neurons and a paternally hypermethylated DMR near the PWAR1 CTCF anchor exclusive to undifferentiated cells, consistent with increases in neuronal transcription. Additionally, DMRs near CTCF loop anchors were observed in both cell types, indicative of allele-specific differences in chromatin loops regulating imprinted transcription. These results provide an integrated view of the 15q11-q13 epigenetic landscape during LUHMES neuronal differentiation, underscoring the complex interplay of transcription, chromatin looping, and DNA methylation. They also provide insights for future therapeutic approaches for AS and PWS.
Engagement with health research summaries via digital communication to All of Us participants
Authors: Ter Meer Janna , Kamyar Royan , Orlovsky Christina , Hung Ting-Yang , Benrey Tamara , Dinh-Luong Ethan , Quer Giorgio , Moore Vogel Julia
Published: July 2024

Objective

Summaries of health research can be a complementary way to return value to participants. We assess how research participants engage with summaries via email communication and how this can be improved.

Materials and Methods

We look at correlations between demographic subgroups and engagement in a longitudinal dataset of 305 626 participants (77% are classified as underrepresented in biomedical research) from the All of Us Research Program. We compare this against engagement with other program communications and use impact evaluations (N = 421 510) to measure the effect of tailoring communication by (1) eliciting content preferences, (2) Spanish focused content, (3) informational videos, and (4) article content in the email subject line.

Results

Between March 2020 and October 2021, research summaries reached 67% of enrolled participants, outperforming other program communication (60%) and return of results (31%), which have a high uptake rate but have been extended to a subset of eligible participants. While all demographic subgroups engage with research summaries, participants with higher income, educational attainment, White, and older than 45 years open and click content most often. Surfacing article content in the email subject line and Spanish focused content had negative effects on engagement. Video and social media content and eliciting preferences led to a small directional increase in clicks.

Discussion

Further individualization of tailoring efforts may be needed to drive larger engagement effects (eg, delivering multiple articles in line with stated preferences, expanding preference options). Our findings are likely a conservative representation of engagement effects, given the coarseness of our click rate measure.

Conclusions

Health research summaries show promise as a way to return value to research participants, especially if individual-level results cannot be returned. Personalization of communication requires testing to determine whether efforts are having the expected effect.
Privacy preserving record linkage for public health action: opportunities and challenges
Authors: Pathak Aditi , Serrer Laina , Zapata Daniela , King Raymond , Mirel Lisa B , Sukalac Thomas , Srinivasan Arunkumar , Baier Patrick , Bhalla Meera , David-Ferdon Corinne , Luxenberg Steven , Gundlapalli Adi V
Published: July 2024

Objectives

To understand the landscape of privacy preserving record linkage (PPRL) applications in public health, assess estimates of PPRL accuracy and privacy, and evaluate factors for PPRL adoption.

Materials and Methods

A literature scan examined the accuracy, data privacy, and scalability of PPRL in public health. Twelve interviews with subject matter experts were conducted and coded using an inductive approach to identify factors related to PPRL adoption.

Results

PPRL has a high level of linkage quality and accuracy. PPRL linkage quality was comparable to that of clear text linkage methods (requiring direct personally identifiable information [PII]) for linkage across various settings and research questions. Accuracy of PPRL depended on several components, such as PPRL technique, and the proportion of missingness and errors in underlying data. Strategies to increase adoption include increasing understanding of PPRL, improving data owner buy-in, establishing governance structure and oversight, and developing a public health implementation strategy for PPRL.

Discussion

PPRL protects privacy by eliminating the need to share PII for linkage, but the accuracy and linkage quality depend on factors including the choice of PPRL technique and specific PII used to create encrypted identifiers. Large-scale implementations of PPRL linking millions of observations—including PCORnet, National Institutes for Health N3C, and the Centers for Disease Control and Prevention COVID-19 project have demonstrated the scalability of PPRL for public health applications.

Conclusions

Applications of PPRL in public health have demonstrated their value for the public health community. Although gaps must be addressed before wide implementation, PPRL is a promising solution to data linkage challenges faced by the public health ecosystem.
Case study: cremophor EL-based liquid formulations as simple substitutes for amorphous solid dispersions in early preclinical in vivo studies
Authors: Sigfridsson Kalle , Zhang Xiang , Llinas Antonio
Published: July 2024

Objectives

The objective of the present case study was to increase the exposure of the poorly soluble crystalline compound A.

Methods

Mice received 10 mg/kg of crystalline compound A formulated in eight different cosolvent, oil, and cyclodextrin mixtures.

Key findings

In all cases, AUC0–24h and maximum blood/plasma concentration (Cmax) were in the range of 6–16 µM × h and <1.4 µm, respectively, with a bioavailability below 18%. When 6% cremophor (CrEL) was added to three selected vehicles, AUC0–24h and Cmax increased ~5–10 times. The obtained pharmacokinetic profile of the most improved formulation using CrEL was possible to superimpose on the one obtained after administration of a CrEL-free amorphous solid dispersion (ASD, HPMC-AS:drug, 80:20) suspension of compound A.

Conclusions

It is crucial to find an optimal screen vehicle as early as possible for a poorly water-soluble lead series and then avoid time and resource-consuming vehicle testing of multiple compounds in vivo. An ASD approach is more suited for clinical development when more time and resources are allocated to the project. In this case study, some preclinical formulations were used to maximize exposure but also as preindicators for ASDs later in the development chain.
Paediatric colorectal surgery
Authors: Blood Alyssa G. , Merianos Demetri J.
Published: July 2024

Paediatric colorectal surgery encompasses a wide variety of disease processes, both congenital and acquired, that affect the colon and rectum. Many of these conditions require surgical intervention during infancy or childhood, with the subsequent need for long-term follow-up by adult colorectal surgeons. The intention of this chapter is to familiarize the reader with the common colorectal conditions encountered and treated by paediatric surgeons. There is particular emphasis on those that may need follow-up later in life by an adult colorectal surgeon. This chapter will also attempt to emphasize the medical and surgical management of each condition, as well as the potential long-term sequelae.
Rectovaginal and rectovesical fistulae
Authors: Sonoda Toyooki
Published: July 2024

Rectovaginal fistulae are abnormal connections between the vagina and the lower gastrointestinal tract, that often lead to debilitating, uncontrolled passage of gas and faecal matter through the vagina. Obstetric injury is the most common cause of an acquired rectovaginal fistula. Despite several options for repair, none has been demonstrated to be superior to the others. When choosing the optimal procedure, we must consider the location of the fistula, its aetiology, and whether there is a concomitant anal sphincter defect. All types of repair are prone to failure and many will require repeat intervention. Options of tissue interposition and faecal diversion should be considered for complex and refractory cases. Rectovesical fistulae are false connections between the rectum and bladder. As in rectovaginal fistulae, various methods of repair have been described. The aetiology of the fistula, its height and size, and local tissue conditions will help to determine the best surgical approach.
Colon cancer surgery
Authors: Ochiai Hiroki , Ishii Yoshiyuki , Watanabe Masahiko
Published: July 2024

In the United States, colorectal cancer is the third most frequent cause of all deaths from malignant neoplasms—there are about 56,000 deaths, and 150,000 patients are affected every year. Various chemotherapeutic drugs and molecular targeted medicines have emerged, and the medical treatment is developing rapidly in recent years. However, the first choice of curative treatment is still the surgical approach. In particular, the advent of laparoscopy has drastically changed the surgical treatment of colorectal cancer, and it has changed colorectal cancer surgery from being invisible surgery to visible surgery. Many innovative surgical instruments have been and will be developed in the future. A combination of great knowledge and skilled techniques with the new devices will lead to excellent outcomes in colon cancer patients.
Ulcerative colitis
Authors: Gordon Benjamin L. , Smith Emily S. , Tricarico Christopher , Wan David W.
Published: July 2024

The prevalence of ulcerative colitis (UC) continues to increase, particularly in newly industrialized countries, and UC is associated with significant morbidity and healthcare costs. UC is thought to arise from an exaggerated immune response to gut flora in genetically susceptible individuals. The diagnosis of UC involves assessment of serum and stool inflammatory markers, endoscopic evaluation, and histologic review. Patients are classified by disease extent and severity by a number of instruments, including the Montreal classification and Mayo score. Treatment goals in UC are both clinical and endoscopic remission. The mainstay of therapy in mild-to-moderate UC is topical 5-aminosalicylates with or without oral 5-aminosalicylates, depending on disease extent. Biologic agents, including anti-tumour necrosis factor and anti-integrin therapies, are first-line treatment options for moderate-to-severe UC. Many UC patients will not achieve remission with medical therapy alone, and will require surgical intervention.
Intestinal stomas
Authors: Pappou Emmanouil P.
Published: July 2024

The creation of an abdominal stoma is a common procedure performed by surgeons as part of treatment for both benign and malignant conditions. Stoma formation can be either permanent or temporary and can be created in an elective or an emergency operation. The most common abdominal stomas are an ileostomy or colostomy. Often stoma creation is performed at the conclusion of a complex and challenging operation. The rate of complications following stoma creation is not insignificant, and care must be taken to adhere to sound surgical techniques. Individuals scheduled for ostomy surgery and those with a new or established stoma can benefit from the services of a certified wound, ostomy, and continence nurse at an ostomy clinic.
Endocrinology
Authors: Karavadra Babu , Haines Richard A. , Sule Medha
Published: July 2024

This chapter focuses on single best answer questions that test knowledge on the endocrinology that is relevant for the MRCOG part 1 examination. A good understanding of the endocrinology that underpins the specialty is important. The endocrinology that underpins the hypothalamic-pituitary-axis is absolutely vital when trying to understand the menstrual cycle and its related pathology. In order to request the appropriate investigations in patients presenting with menstrual disturbance, a fundamental understanding of basic endocrinological processes will help with this. Applied endocrinology is also seen in the antenatal clinic either preconceptionally or during pregnancy; with diabetes being extremely common within this context.
Microbiology
Authors: Karavadra Babu , Haines Richard A. , Sule Medha
Published: July 2024

This chapter focuses on single best answer questions that test knowledge on the microbiology that is relevant for the MRCOG part 1 examination. An understanding of the principles that underpin medical microbiology is important. An understanding of the common infections that can impact the pregnancy mother and her unborn baby is vital to ensure the patient is referred to the most appropriate healthcare practitioner. Within the context of gynaecology, sexually transmitted infections are not uncommon and therefore a thorough understanding of this is essential. In clinical practice, knowledge of medical microbiology is often applied within the context of interpreting investigations.
General Surgery Board Review
Authors: Morchi Ravi
Published: July 2024

Comprehensive Surgical In-Service and Board Review compiles all the principles and clinically relevant facts of general surgery, serving as a primary reference for residents during their training. It provides a fundamental understanding of surgical specialties, the opportunity for improved clinical performance, and an avenue for residents to reach their potential on yearly in-service training exams and the national board exam. The author consistently performed in the 99th percentile on in-service exams every year, and achieved one of the highest national board exam certification scores. Introductory chapters span cellular and tissue mechanics to microorganisms and antimicrobials; hematology; anesthesia and perioperative care. The majority of the text is organ-system based, progressing through diagnosis and treatment of the alimentary tract and solid organ adjuncts. Additional areas are dedicated to critical care, trauma, and pediatrics. High yield facts in neurosurgery, orthopedics, thoracic, vascular, urology and gynecology are also included.
Colon
Authors: Morchi Ravi
Published: July 2024

The anatomy and physiology of the colon as an organ of transport and fluid absorption is reviewed. Diagnostic tests, with a focus on colonoscopy and polyp management, follows. The next section is dedicated to colon adenocarcinoma, medical and surgical management including details of the various types of colectomy and proctectomy, as well as qualifications for transanal excision, metastasectomy, and adjuvant and neoadjuvant therapy. Commonly tested familial syndromes are described. The latter portion of the chapter is about benign colon disease including diverticulitis, ulcerative and Crohn’s colitis, and ischemic and infectious colitis. Key points in diagnosing and managing colonic bleeding and obstruction are highlighted, as well as commonly tested complications of stomas. A portion of the chapter is focused on benign and malignant appendiceal pathology.
Biliary Tract
Authors: Morchi Ravi
Published: July 2024

The anatomy of the biliary tree and composition of bile and gallstones are reviewed. The physiology of bile excretion and its regulation are discussed. Diagnosis and management of calculous and acalculous cholecystitis are described in detail. The role of endoscopic retrograde cholangiopancreatography (ERCP) and cholecystostomy tubes are summarized. The pathophysiology of gallbladder adenocarcinoma and its treatment algorithm is outlined. The chapter then moves on to biliary duct pathology: choledocholithiasis, infection, injury, stricture, and choledochal cysts. This section closes with a discussion of cholangiocarcinoma, biliary cirrhosis, and sclerosing cholangitis.
Hernia
Authors: Morchi Ravi
Published: July 2024

This chapter reviews all types of abdominal wall, inguinal, and pelvic floor hernias. The anatomy, myofascial layers, neural, and vascular considerations are described specific to each hernia. Indications for emergent and elective operation vary by hernia type. Open and laparoscopic techniques are described, as well as the myriad of complications. Indications and contraindications for component separation and mesh placement are summarized. The chapter closes with a synopsis of parastomal hernias and their management, as well as a list of commonly tested abdominal wall and peritoneal lining pathology.
Pediatrics
Authors: Morchi Ravi
Published: July 2024

A review of the essentials of pediatric surgery for any general surgeon embarking on a clinical rotation or their general board examination. It starts with volume principles and fluid management of the pediatric patient. Pathology is then reviewed by organ-system, including neck masses, airway and parenchymal respiratory malformations, diaphragmatic and torso envelope abnormalities, common hepatic disorders, common non-neural pediatric tumors, and a summary of each major alimentary tract aberrancy and emergency. The chapter ends with commonly tested miscellaneous malformations.
Vascular
Authors: Morchi Ravi
Published: July 2024

This chapter spans all of vascular surgery, from the pathophysiology of plaque to steno-occlusive disease across all surgically accessible vascular territories—carotid, upper limb, thoracic and abdominal aorta, mesenteric, visceral, and lower extremities. Diagnostic workup and an array of treatment options are described to guide the surgeon clinically as well as in a testing situation. There are sections dedicated specifically to aneurysmal disease, aortic dissection, hemodialysis access, endovascular repair, acute limb ischemia, and principles of amputation. All manner of venous and lymphatic disease are reviewed as well. The chapter closes with acute and chronic mesenteric ischemia and other miscellaneous, commonly tested, arterial pathology.
The impact of acute kidney damage in the community
Authors: Diaz Javier , Lidon Laura , Sauri Inma , Fernandez Antonio , Grau Maria , Gorriz Jose L , Forner Maria J , Redon Josep
Published: July 2024

Background and hypothesis

The aim was to assess incidence of acute kidney disease and disorders (AKD) and acute kidney injury (AKI) episodes and their impact on progression of renal dysfunction and risk of all-cause mortality in the community.

Methods

Community of 1 863 731 aged >23 years with at least two serum creatinine measurements. eGFR was calculated using the chronic kidney disease (CKD)-EPI formula. CKD, AKD and AKI were defined according to the harmonized KDIGO criteria (Lameire 2021). The sCr values and Risk, Injury, Failure, Loss, End-stage (RIFLE) scale was used to classify episodes. Progression of renal dysfunction and mortality were evaluated.

Results

A total of 56 850 episodes of AKD in 47 972 patients over 4.8 years were identified. AKD incidence of AKD was 3.51 and 12.56/1000 patients/year in non-CKD and CKD, respectively. One AKD episode was observed in 87.3% patients, two in 9.3%, and three or more in 3.4%. A second episode was less common in patients without CKD (10.3%) compared to those with CKD (18.4%). Among patients without CKD a total of 43.8% progressed to CKD, and those with previous CKD 63.1% had eGFR decline of >50%. The risk of progression to CKD was higher in women, older, overweight-obesity, and heart failure, as was the risk of eGFR decline >50% in CKD patients, although the number of AKD episodes was also a risk factor. AKI episodes were observed in 5646 patients with or without CKD. Of these, 12.7% progressed to CKD and of those with pre-existing CKD, 43.2% had an eGFR decline of >20%. In the total population, mortality within 3 months of detection of AKD episode occurred in 7% patients, and was even higher in patients with AKI at 30.1%.

Conclusion

Acute elevations in serum creatinine in the community may pose a health risk and contribute to the development of CKD. Identification of therapeutic targets and provision of appropriate follow-up for those who survive an episode is warranted.
Treatment of locally advanced pancreatic cancer using localized trans-arterial micro perfusion of gemcitabine: combined analysis of RR1 and RR2
Authors: Hatoum Hassan , Rosemurgy Alexander , Bastidas J Augusto , Zervos Emmanuel , Muscarella Peter , Edil Barish H , Cynamon Jacob , Johnson D Thor , Thomas Christopher , Swinson Bradley M , Nordgren Aaron , Vitulli Paul , Nutting Charles , Gipson Matthew , Tsobanoudis Alex , Agah Ramtin
Published: July 2024

Background

Locally advanced pancreatic cancer (LAPC) comprises 40% of pancreatic cancer diagnoses and has a relatively poor prognosis. Trans-arterial micro perfusion (TAMP)-mediated chemotherapy delivery to the primary tumor is a novel approach worthy of investigation. The RR1 (dose escalation) and RR2 (observational) studies examined the safety and preliminary efficacy of TAMP-delivered gemcitabine for LAPC.

Patients and Methods

RR1 and RR2 data were pooled. Both studies enrolled patients with LAPC with histologically confirmed adenocarcinoma. Participant data, including age, sex, race, stage, previous treatments, toxicity, disease progression, and death, were collected. Median number of cycles and average treatment dosage were calculated. Overall survival (OS) was determined for the whole group and separately for patients who received and did not receive previous treatments. Aims of the analysis were to assess procedure safety, OS, and evaluate factors associated with OS.

Results

The median age of the 43 patients enrolled in RR1 and RR2 was 72 years (range, 51-88 years). Median OS for the 35 eligible patients with stage III disease was 12.6 months (95% CI, 2.1-54.2 months). Previous chemoradiation was associated with significantly longer OS [27.1 months (95% CI, 8.4-40.6 months)] compared to previous systemic chemotherapy [14.6 months (95% CI, 6.4-54.2 months)] or no prior treatment [7.0 months (95% CI, 2.1-35.4 months)] (P < .001). The most common adverse events were GI related (abdominal pain, emesis, and vomiting); the most common grade 3 toxicity was sepsis.

Conclusion

Study results indicate that TAMP-mediated gemcitabine delivery in patients with LAPC is potentially safe, feasible, and provides potential clinical benefits.

Clinical Trial Registration

NCT02237157 (RR1) and NCT02591082 (RR2).
Intellectual Journeys towards Emotions: A Conversation among Feminist Scholars
Authors: Barua Rukmini , Lämmert Stephanie , Sarıoğlu Esra , Wambach Julia
Published: July 2024

This Viewpoint contribution considers the recent turn to emotion and affect in the humanities and the social sciences. We present here a conversation between four scholars of gender, Ute Frevert, Chitra Joshi, Lynn M. Thomas and Valerie Walkerdine, reflecting on their personal intellectual trajectories. In their discussion, they examine how, when and why they began to explore the analytical potential of feelings and emotions in their scholarly work. The turn to emotions was motivated by a search for more nuanced perspectives on social hierarchies, and subjectivity and agency. Through their respective expertise on western Europe, India, East and Southern Africa and Britain, the four scholars address the global connections between studies of gender and the increasing import of emotions as an analytical lens.
Against a global conception of mathematical hinges
Authors: Fairhurst Jordi , Pérez-Escobar José Antonio , Sarikaya Deniz
Published: July 2024

Epistemologists have developed a diverse group of theories, known as hinge epistemology, about our epistemic practices that resort to and expand on Wittgenstein's concept of ‘hinges’ in On Certainty. Within hinge epistemology there is a debate over the epistemic status of hinges. Some hold that hinges are non-epistemic (neither known, justified, nor warranted), while others contend that they are epistemic. Philosophers on both sides of the debate have often connected this discussion to Wittgenstein's later views on mathematics. Others have directly questioned whether there are mathematical hinges, and if so, these would be axioms. Here, we give a hinge epistemology account for mathematical practices based on their contextual dynamics. We argue that 1) there are indeed mathematical hinges (and they are not axioms necessarily), and 2) a given mathematical entity can be used contextually as an epistemic hinge, a non-epistemic hinge, or a non-hinge. We sustain our arguments exegetically and empirically.
Social Protections and Climate Migration: Service Navigation among Puerto Ricans Displaced by Hurricane Maria
Authors: Hodges James C , García Maria F , Schwartz Seth J , Vaughn Michael G , Maldonado-Molina Mildred M , Bates Melissa , Calderón Ivonne , Brown Eric C , Rodríguez José , Salas-Wright Christopher P
Published: July 2024

As climate change continues to displace greater numbers of people, transnational ties are important sources of social protection for climate migrants. Migrants assemble unique configurations of formal and informal social protections depending on the resources available within their sending and receiving communities. However, the specific constellations of social protections that climate migrants use following disaster and displacement remain underexamined. Authors conducted semistructured interviews with Puerto Ricans who migrated in the aftermath of Hurricane Maria (N = 41) and used qualitative content analysis to trace the assemblages of formal and informal social protections used to navigate the resettlement process. Results suggest that informal support from migrants’ transnational ties was instrumental in successfully making use of formal sources of support, including federal emergency relief programs, to leave the island and resettle on the U.S. mainland. This reliance on informal social protections often strained participants’ informal networks and raised questions of equity for people internally displaced by climate change. These findings highlight the need for a more equitable and effective linkage of climate migrants with public resources.
5Ecocriticism
Authors: Ryan John Charles
Published: July 2024

Over the last two decades, the Anthropocene and its calamitous signatures of climate upheaval, species loss, and biocultural fragmentation has garnered dedicated attention from ecocritics, ecologists, and the public. As the culmination of a fifteen-year scientific process, however, in early 2024, the International Union of Geological Sciences, or IUGS, rejected the Anthropocene as a unit of geological time in favour of a view of the Anthropocene as a temporally transgressive event. Prominent within the year’s work are trajectories in empirical ecocriticism, ecocritical ageing studies, intermedial ecocriticism, and blue ecocriticism, all of which place emphasis on agency, narrativity, and temporality. As the example of the blue humanities reveals, explored in this essay’s conclusion, intersections between ecocriticism and emerging areas of the environmental humanities continue to generate novel directions. The expansion of interdisciplinary research engaging ecocritics, social scientists, ecologists, and geoscientists is a potential outcome of the IUGS decision. As ecocriticism evolves in the era of the Anthropocene as an event, concerns of more-than-human agency, expression, and creativity will likely attract greater focus.

In addition to presenting a broad overview of publications, each of the sections below hones in on one specific work. This review of ecocritical publications in 2023 comprises six sections: 1. Introduction: The Anthropocene from Epoch to Event, which contextualizes the IUGS’s refusal to ratify the Anthropocene as an official geochronological designation; 2. Ecocritical Directions: Towards More-than-Human Agencies, which focuses on the special issue of the journal Anthropocenes, ‘Life Out of Place’; 3. Empirical Ecocriticism: Appraising Environmental Narratives, which considers the landmark edited collection Empirical Ecocriticism; 4. Ecocritical Ageing Studies: Rethinking Narratives of Decline, which turns to the edited collection Aging Studies and Ecocriticism; 5. Intermedial Ecocriticism: Diversifying Anthropocene Narratives, evaluating Jørgen Bruhn and Niklas Salmose’s monograph Intermedial Ecocriticism; and 6. Conclusion: Ecocritical Agency and the Environmental Humanities, which reflects on developments in the blue humanities.
1Affect Theory
Authors: Warren Jack
Published: July 2024

This review concerns the interconnections between the theory and practice of affect, where both are understood as a spiral dance that is intimate and entangled, troubled and tense. Specifically, it will review the year’s work in affect theory through the bind of practice and theory and consider how practices have attempted to record feelings, as well as whether such recording is at all possible. This idea is drawn from Gregory J. Seigworth and Carolyn Pedwell’s introduction to The Affect Theory Reader 2. The two get into the sticky, intractable, reverberating, grasping, rhythmic, and touchy-feely capacities of affects that render them, as Jasbir K. Puar puts it, ‘a site of bodily creative discombobulation and resistance’ (‘Prognosis Time’ [2009], p. 161). But Seigworth and Pedwell hold: ‘Of course this is easy to assert in theory but much harder to pull off in practice’ (p. 10). Much of The Affect Theory Reader 2 calls attention to how theory and practice co-constitute each other rather than oppose one another. This co-constitution can be messy and troubling, but, as Seigworth and Pedwell contend, such ‘ambiguities, overdeterminations, clots, tensions, and stuckness’ are the ‘initiating condition’ (p. 15) of affect theory. To lean into uncertainty, muddle through entanglements, trace the intractable, attend to the sensory, and attune to the excesses of bodies are all practices of affect theory. To quote Seigworth and Pedwell once more: ‘When something sticks, practice begins to turn to saturation—or maybe almost nothing sticks, then it is all on the fade—or sometimes, you are left half-suspended and middling through’ (p. 16). This review, then, considers works with specific apparatuses that reveal, relay, transmit, or determine the conditions of affect. These are the apparatuses that make the stickiness of affect apparent. The review is divided into three sections, each naming a distinct apparatus: 1. Autotheory; 2. Archives; 3. Laboratories. All the works in this review concern these three apparatuses or are scaffolded by them in their contact with affect. The concluding section, 4. Final Thoughts, considers how these works, whether congruous in their position on the recording of feelings or not, showcase the entanglement of theory and practice and demonstrate that affects in practice are as shimmering as affects in theory.
Readmission Rates After Expedited Postpartum Discharge
Authors: Walia Anjali , Friedman Alexander M. , Sobhani Nasim C. , Wen Timothy
Published: July 2024

OBJECTIVE:

To characterize national trends in expedited postpartum discharge and, secondarily, to identify predictors of expedited postpartum discharge and assess whether expedited postpartum discharge was associated with postpartum readmissions within 60 days of delivery hospitalization discharge.

METHODS:

Birth hospitalizations and subsequent 60-day postpartum readmissions were extracted from the 2016–2020 Nationwide Readmissions Database for this retrospective cohort study. Postpartum discharge was categorized as expedited (less than 2 days after vaginal birth or less than 3 days after cesarean birth), routine (2 days after vaginal birth or 3 days after cesarean birth), or prolonged (more than 2 days after vaginal birth or more than 3 days after cesarean birth). Trends in expedited discharge were assessed over the study period with joinpoint regression. Unadjusted and adjusted logistic regression models were performed to assess clinical, hospital, and demographic predictors of expedited postpartum discharge. Sixty-day postpartum readmission risk was calculated, and adjusted regression models were performed to evaluate the association between expedited postpartum discharge and readmission.

RESULTS:

Of 17.9 million birth hospitalizations, 32.9% had expedited postpartum discharge. The overall 60-day postpartum readmission rate after delivery hospitalization discharge was 1.7% for all patients, 1.4% for expedited postpartum discharge, 1.6% for routine discharge, and 3.3% for prolonged discharge. Rates of expedited postpartum increased from 29.1% in 2016 to 31.4% in 2019 and to 43.8% in 2020. This trend was not significant (average annual percent change: 9.9%, 95% CI, −1.6% to 23.7%), although rates of expedited discharge were significantly higher in 2020 than in 2016–2019 (P<.01). Younger and older age, chronic comorbid conditions, mental health conditions, and obstetric complications (eg, transfusion, chorioamnionitis or endometritis) were associated with lower likelihood of expedited postpartum discharge. Expedited postpartum discharge was associated with 14% lower adjusted odds of 60-day postpartum readmission compared with routine discharge (adjusted odds ratio 0.86, 95% CI, 0.85–0.88).

CONCLUSION:

Rates of expedited postpartum discharge increased significantly in 2020 compared with 2016–2019 and were not associated with 60-day postpartum readmission. These findings suggest that broader use of expedited postpartum discharge has not resulted in increased risk of postpartum readmissions.