bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diffusion and Pulmonary Diffusion Capacity
Authors: Moldysz Anna , Sharma Archit 
Published: May 2024

Abstract
One of the major roles of the lungs is to facilitate gas exchange from the circulatory system and the external environment. Gas exchange occurs in the lungs between alveolar air and blood of the pulmonary capillaries. A test of the diffusing capacity of the lungs for carbon monoxide (DLCO, also known as transfer factor for carbon monoxide or TLCO), is a valuable test of lung function, specifically before undergoing an operation. This can be helpful in predicting patients at higher risk for postoperative complications following lung volume reduction surgery (LVRS) and overall postoperative pulmonary morbidity.
Beta (β) Agonists
Authors: Markatos Sheridan , Manders Larry 
Published: May 2024

Abstract
Beta receptors are part of the sympathetic nervous system and are stimulated by the catecholamines epinephrine and norepinephrine. There are three types β1, β2, and β3 receptors. This chapter focuses on β2 receptors and their agonists. Bronchodilation occurs when β2 receptors are stimulated by epinephrine, and less so norepinephrine. Ultimately, activation prevents contraction of the smooth muscles in the airway, dilating the airway, and decreasing airway resistance. There are two classes of beta agonists: short and long. This chapter reviews beta receptors, beta agonists, and utilization in the perioperative setting.
Perioperative Use of Alcohol
Authors: Cieslinski Lindsey 
Published: May 2024

Abstract
As an anesthesiologist, it is imperative to identify alcohol misuse in the perioperative period. It is estimated that anywhere between 10% and 20% of surgical patients meet criteria for alcohol dependence or abuse. When patients are not as forthcoming about their total alcohol consumption, the clinical picture combined with objective findings can aid in diagnosis and perioperative management. Compared to individuals who drink infrequently, those who heavily consume alcohol, whether in the acute setting or chronically, are predisposed to multiple perioperative complications. Patients who regularly consume high volumes of alcohol have an increased tolerance to many sedative drugs and are at increased risk of hepatic disease which can impact the choice of anesthetic agents. Common perioperative complications include infection, sepsis, bleeding, delayed wound healing, liver dysfunction, and cardiac dysfunction. Chronic alcoholism leads to a variety of electrolyte abnormalities, mostly due to poor nutritional intake and malabsorption. This chapter discusses the pathophysiology of alcoholism predisposing these patients to perioperative complications, along with the anesthetic considerations and management strategies.
Cocaine Pharmacology
Authors: Cieslinski Lindsey 
Published: May 2024

Abstract
Cocaine came into Western medicine as the first local anesthetic, unique due to its combined properties of local anesthesia with intense vasoconstriction. Today in modern medicine, cocaine can be used as a topical intranasal anesthetic agent for sinus surgery or, less commonly, for awake intubation in a 4% solution. It is an illicit drug originating from the leaves of the erthryoxylon coca plant that is both harmful and dangerous to the human body due to its toxic abilities and highly addictive properties. This effect can carry over to the perioperative period, creating a potentially challenging anesthetic scenario due to the numerous physiologic effects of cocaine. In addition to local anesthetic effects, cocaine has both peripheral and centrally acting sympathomimetic actions. This chapter discusses the pharmacologic and physiologic effects of cocaine while considering the anesthetic implications.
Systolic and Diastolic Function
Authors: Al-Attar Neal , Manders Larry 
Published: May 2024

Abstract
Systolic and diastolic function of the heart is complex relation of pressure, volume, and contractility over a period of time. The preload or venous return to the heart, as well as the afterload, greatly changes the ability of the heart to pump. This chapter briefly discusses the governing force on the heart in terms of systolic and diastolic function in addition to identifying some alterations that may occur during the delivery of anesthesia.
Vessel Function
Authors: Yousef John , Manders Larry 
Published: May 2024

Abstract
Five types of vessels exist in the body to carry oxygenated blood to the tissues and take deoxygenated blood away from them. These are the arteries, arterioles, capillaries, venules, and veins. The exchange between cellular waste and nutrition takes place at the level of the capillaries. Substances such as water, oxygen, carbon dioxide, and glucose are supplied and removed. This chapter briefly discusses the anatomical composition of the different vessel types and their function. Furthermore, it highlights changes among vessel groups during general anesthesia.
Systemic, Pulmonary Vascular Resistance and Viscosity
Authors: Huarte Maria , Chhabada Surendrasingh 
Published: May 2024

Abstract
Systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR) are the resistances that the left and right sides of the heart must overcome to generate flow through the circulatory system. Each of the systemic and pulmonary circuits has its unique characteristics and regulation, but since they are connected in series, flow must be equal to sustain life. The systemic circulation is characterized by high pressure and resistance, while the pulmonary one has low pressure and resistance. Since under normal conditions systemic and pulmonary pressures are maintained relatively constant, flow is highly dependent on resistance. The Hagen-Poiseuille equation underlines the impact of the vessel radius and blood viscosity on SVR and PVR (and ultimately on blood flow). It is important for the anesthesiologist to understand how different factors impact the hemodynamics of both the systemic and pulmonary circulations when caring for an increasingly complex patient population.
Regional Blood Flow and Its Regulation
Authors: Walia Anureet , Sharma Archit 
Published: May 2024

Abstract
Control of blood flow to tissues is vital to maintaining adequate but not excessive nutrient supply and removal of waste products. The anatomy and physiology of the endothelium and vascular smooth muscle allow tissues to regulate blood flow to match supply to demand in the face of a wide range of systemic changes. Different organ systems follow different control mechanisms to increase or decrease the amount of blood flowing through them. This chapter discusses the key aspects of this process, including structural features, mechanisms of autoregulation, and the fundamental roles of the endothelium and vascular smooth muscle.
Blood Filters and Pumps
Authors: Prem Anand , Anand Suwarna 
Published: May 2024

Abstract
Blood transfusion therapy is an integral part of the anesthetic management of patients in the setting of intraoperative acute blood loss and hemodynamic instability. While transfusion of blood products can be lifesaving, it is an intervention that has potential risks to the patient as well. Over the last several decades, the infectious risks of blood product transfusions have been significantly reduced by appropriate screening of donors and blood products. Hemolytic transfusion reactions have been reduced by more stringent guidelines to ensure the “right product gets to the right person.” The practice of leucocyte reduction of blood components has reduced the risks of febrile nonhemolytic transfusion reactions, transmission of cytomegalovirus, and platelet refractoriness, largely eliminating the need for leucocyte filters. However, it is universally recognized that microaggregates of fibrin clots and cellular debris that form when blood is stored need to be filtered out prior to administering blood products to patients. Blood transfusion sets currently available are routinely equipped with 170–200 micron filters, and the use of these filters during transfusion of all blood products except for hematopoietic precursor cells is considered “standard of care” throughout the developed world. A variety of pumps are available to help regulate the speed of infusion of blood products without inducing hemolysis, and some of these are equipped with the ability to warm the products to offset the risk of arrythmias and coagulopathy, particularly during massive blood transfusion protocols.
Anesthetic Considerations for Reactions to Transfusions
Authors: Rose John 
Published: May 2024

Abstract
Blood products can be a life-saving intervention in the perioperative period, but it is important to transfuse judiciously. Febrile, allergic, and hemolytic transfusion reactions each have a specific mechanism of action, clinical manifestation, and treatment requirement. The presentation of these reactions ranges from the relatively benign, such as afebrile and urticarial reactions, to more severe presentations, like anaphylactic and hemolytic reactions. Mild reactions may only require the provider to monitor the patient throughout their transfusion, while severe reactions can necessitate more aggressive interventions. This chapter examines the pathological mechanisms, common patient presentations, and treatment modalities for these reactions. Preoperative, intraoperative, and postoperative management is also reviewed.
Parathyroid Anatomy and Physiology
Authors: Prejean Rosemary , Kaye Alan D. 
Published: May 2024

Abstract
Parathyroid anatomy and physiology have enormous clinical implications. A concise review of general parathyroid anatomy, focusing on pertinent landmarks for identification, and specific details of physiological function of parathyroid hormone (PTH) are presented in this chapter. Details of interactions between PTH, calcitonin from the thyroid gland, and dietary vitamin D that maintain calcium homeostasis in the body are discussed. Control of PTH release from the parathyroid glands by concentrations of calcium, phosphate, and magnesium in the blood are presented, with specific discussion on actions of PTH at the kidney and bone leading to an overall increase in serum calcium, decrease in serum phosphate, and activation of vitamin D. Appreciation of parathyroid anatomy and physiology is the basis for best practice management of surgical removal of the parathyroid glands or in pathophysiological states that alter parathyroid-related homeostasis, in particular calcium, phosphate, and magnesium levels.
Carbohydrates
Authors: Torres Felipe Vasconcelos , Montagner Rossi Raquel 
Published: May 2024

Abstract
This chapter discusses the highlights of carbohydrate metabolism. Glucose plays a central role in energy generation by cells. Glucose molecules can be stored as glycogen by the body, or can be oxidized for the formation of nucleotides (pentose phosphate pathway) or for energy (glycolytic pathway). Glycolysis is the oxidation of the glucose molecule into pyruvate, and it can occur under aerobic or anaerobic conditions. When oxygen is available (aerobic metabolism), pyruvate becomes acetyl-CoA and enters the TCA cycle. This is followed by oxidative phosphorylation inside mitochondria, which leads to the generation of substantial amounts of energy. When oxygen availability is reduced (e.g., in anemia, hypovolemic shock, cardiogenic shock, obstructive shock, or strenuous exercise), cells rely on anaerobic glycolysis for energy and excess pyruvate is converted to lactate. Some tissues (e.g., liver and heart) can utilize lactate found in the bloodstream for energy.
Effects of Stress
Authors: Spence Allyson L. , Cornett Elyse M. 
Published: May 2024

Abstract
Stressors activate the “fight or flight” response, a protective mechanism of the body to adapt to and prepare for challenging situations. Overall, prolonged stress can lead to and/or worsen endocrine disorders and can produce a reduction in neuroprotective hormones. Overactivation of the hypothalamic-pituitary-adrenal (HPA) axis can cause fatigue, decreased cognitive abilities, and an increased risk of developing metabolic and psychiatric diseases, and increased immune response. This up-regulation of the immune system increases these individuals’ susceptibilities to developing inflammatory diseases, such as acute stress disorder. The perioperative period is associated with acute stress that can exacerbate symptoms of pain, anxiety, the surgical stress response, and the potential of anesthetic agents to produce neurotoxicity. Anesthesiologists should make conscious efforts to reduce this acute perioperative stress, and thus improve patient outcomes.
Perioperative Management of Insulin
Authors: Kim Jonathan I. , Schulman Nathan 
Published: May 2024

Abstract
Perioperative insulin management for the diabetic patient is critical to ensure optimal patient outcomes. It is particularly important for the anesthesiologist to understand given the fact that 9% of the US population has diabetes. This chapter discusses the importance of avoiding both hypoglycemia and hyperglycemia throughout the perioperative process. It addresses the preoperative planning for diabetic patients. It also discusses intraoperative strategies for insulin management, depending on the patient’s level of insulin dependence and the type and length of surgery they undergo. And finally, it discusses postoperative management.
Lipids
Authors: James Dominika Lipowska , Ghanavatian Shirin 
Published: May 2024

Abstract
Lipids are a structurally very diverse group of hydrophobic molecules broadly divided into fats, oils, and steroids. Lipids are essential to many biochemical processes, as well as the structural integrity of living organisms. Lipids form the building blocks of cellular membranes, serve as an energy source, and are involved in immune function and cellular communication in the form of hormones and steroids. Steroids are a varied group of molecules contributing to an organism’s proper growth and sexual development, metabolic function, and immune defense. Cholesterol is a precursor of sex steroids, cortisol, and aldosterone, as well as vitamin D. Cholesterol is also a substrate for bile salt production. Cholesterol, being a hydrophobic molecule, requires lipoproteins for transport in plasma. Elevation in cholesterol and triglycerides, called hypercholesterolemia and hyperlipidemia respectively, has been associated with increased risk for cardiovascular disease.
Ethics
Authors: Hanna Joseph Salama , Saad Ramsey 
Published: May 2024

Abstract
This chapter reviews the main concepts of HIPAA, advance directive, and discussions involving the possibility of DNR suspension during surgical procedures. HIPAA in its core includes specific regulations designed to protect the privacy of an individual’s health records. Advance directive is the way healthcare providers can learn about the patient’s wishes regarding his or her medical care in a situation in which the patient cannot speak for him- or herself. Discussion, as well as clear documentation of the code status before any surgical or interventional procedure, is very important and should take place before proceeding. Plan for intra- and postoperative code status should be clearly outlined and documented.
Core Competencies
Authors: Hanna Joseph Salama , Saad Ramsey 
Published: May 2024

Abstract
The Six Core Competencies, adopted by ABMS and ACGME in 1999, are recognized as integral to quality patient care. Most medical boards integrate learning and assessment of the six competencies throughout their process for Initial Certification in a manner that best serves the needs of patients cared for by diplomates, and that is relevant to the practice of their respective specialties and to the specific type of practice of a candidate. The six competencies are practice-based learning and improvement, patient care and procedure skills, systems-based practice, medical knowledge, interpersonal and communication skills, in addition to professionalism. This chapter presents a brief description of these competencies.
Approach to Anesthesiology Exams
Authors: Cole Dooley F. , Ching Adrian 
Published: May 2024

Abstract
During anesthesiology residency, trainees work countless hours gaining exposure to a wide variety of clinical specialties, and there is a significant amount of content to master. To judge progress toward this knowledge goal and competency as a consultant anesthesiologist, the trainee will sit for at least six exams, three in-training, one BASIC, one ADVANCED, and one APPLIED exam. The goal of this chapter is to provide background and basic information on the tests, discusses the differences between learning material and studying for standardized exams, as well as helpful information for how to study for these exams. Information is also included to help when the candidate must guess between answers.
How Technology, Social Media, and Current Events Profoundly Affect Adolescents
Authors: Goldstein M.D. Mark A. , Chandler Goldstein Myrna 
Published: May 2024

Abstract
How Technology, Social Media, and Current Events Profoundly Affect Adolescents examines 18 contemporary issues and their impact on the biological, psychological, and social domains in adolescents. Using research and clinical studies in each chapter, it reviews biological issues that include sleep, obesity, and stress. The mental health section contains chapters on anxiety, depression, eating disorders, substance use, and suicidality/self-harm. In the section on social issues, cyberbullying, problematic internet use, racism/discrimination, LGBTQ, transgender and gender dysphoria, poverty, divorce, and bereavement and mortality are studied. An analysis of current events including the COVID pandemic and war completes the book. There are multiple recurring themes including the importance of positive role modeling by parents, teachers, and clinicians; the harms and benefits from new technologies including social media; and the complex interrelationships that an issue has with the other issues reviewed. In addition, the impact on adolescents’ biopsychosocial domains from the perspective of the social determinants of health is reviewed. Each chapter also has a section on prevention and treatment. This book is written for a broad audience including primary care physicians, psychiatrists, psychologists, social workers, sociologists, trainees in these fields, as well as parents, teachers, and administrators.
Stress
Authors: Goldstein Mark A. , Goldstein Myrna Chandler 
Published: May 2024

Abstract
Stress is ubiquitous to all of us. While a person’s reaction to acute stress may be lifesaving, the response to chronic stress may negatively impact health. Chronic stress for adolescents may include psychological abuse, personal or parental physical or mental illness, and physical or emotional neglect. Stressful experiences are a major cause of anxiety disorders in adolescents, and early stress from adverse childhood events increases the risk that adolescents will develop depression. Poverty is also an early life stressor. With social media, adolescents may experience digital stress, which is caused by negative interactions in emails, texts, chat rooms, and various types of forums. The death of a parent, especially during adolescence, can be a devastating stressor for teens. Exercise and mindfulness may be helpful in reducing stress for adolescents.
Anxiety
Authors: Goldstein Mark A. , Goldstein Myrna Chandler 
Published: May 2024

Abstract
Even though everyone experiences some anxiety, researchers have yet to determine why certain teens develop an anxiety disorder. There are known biological, psychological, and social factors that interact to trigger an anxiety disorder. Genetic factors play an important role in determining which adolescents will have a problem with anxiety. It is generally believed that there is no single gene that directs the onset of anxiety; rather, it may be the cumulative effect of many genes. In addition, children of anxious parents are at increased risk for developing an anxiety disorder. Moreover, there appears to be a positive association between social media use and anxiety in adolescents. Violence in any form including school shootings can produce an acute stress reaction that includes anxiety. In the long term, some witnesses to such violence may develop posttraumatic stress disorder.
Suicidality and Self-Harm
Authors: Goldstein Mark A. , Goldstein Myrna Chandler 
Published: May 2024

Abstract
Suicide is the third leading cause of death in youth ages 15 to 19 years in the United States; most adolescents who die from suicide have a mental health disorder including depression, oppositional defiant or conduct disorder, attention-deficit/hyperactivity disorder, or bipolar disease. Adolescents continue to spend a significant amount of time on social media, an activity that has been correlated with depression and suicide-related outcomes, while they are spending less time on nonscreen activities including sports and exercise. Discrimination, racism, and minority sexual orientation have been identified as risk factors. Parents, teachers, coaches, clergy, and others should carefully observe adolescents for signs of suicidality; routine screening should be performed on a periodic basis by a clinician. Early referral for treatment is critical.
Racism and Discrimination
Authors: Goldstein Mark A. , Goldstein Myrna Chandler 
Published: May 2024

Abstract
Racism is ubiquitous in the United States, and it has profound effects on racial, gender, and sexual minority adolescents. It impacts the biopsychosocial health of adolescents in numerous ways including reducing opportunities for education and shelter; directly affecting cognitive and emotional processes; diminishing opportunities for healthy food, exercise, and sleep; and increasing exposure to violence. Structural racism is a driver of adolescent obesity through housing segregation that may limit food and exercise choices. A perception of discrimination among Latino adolescents has been associated with recent and lifetime use of substances. And social media platforms have been vehicles of online vicarious and individual racial discrimination against adolescents. Racism is a significant public health problem that should be dismantled. This will require dramatic changes in systematic, institutional, and individual racism as well as the concept of White privilege.
Poverty
Authors: Goldstein Mark A. , Goldstein Myrna Chandler 
Published: May 2024

Abstract
Forty percent of American children live in poverty or near poverty, and these economic states are associated with health disparities. Childhood poverty and family adversity affect biopsychosocial outcomes for adolescents, leading to higher chances for obesity, mental health problems, and violent behavior. Poverty may also lead to a digital divide where affected adolescents lack access to computers, smartphones, or home networks. Those adolescents living in poverty are at risk for structural racism, leading to unequal access to resources, rights, power, and protection. Immigrant children and adolescents are likely to live in poverty, and they are more likely than those not living in poverty to have impacts on their learning that are mediated by structural brain development issues. Multiple strategies are needed to modify the influence of poverty on adolescents.