bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative Pain Management for Living Liver Donor
Authors: Polshin Victor , Said Engy T. 
Published: April 2023

Abstract
Acute postoperative pain management for patients undergoing open hepatectomy is often severe. The procedure entails a large upper abdominal incision the majority of these patients are healthy and undergo this procedure for altruistic reasons. It is important to reduce the impact of the surgery on them. The postoperative physiologic and pain are challenging and affect the recovery markedly. Proper treatment of postoperative pain is a big factor in their recovery and satisfaction. This chapter discusses the various pharmacologic as well as procedural options, for the management of postoperative pain in this patient population. The chapter will discuss the limitations of the neuraxial procedures and the pros and cons of all the treatments.
Regional Anesthesia for Abdominoplasty
Authors: Ahuja Sanchit , Kolli Sree 
Published: April 2023

Abstract
Lipoabdominoplasty refers to extensive liposuction in conjunction with abdominoplasty— known to improve outcomes and simultaneously reduce the risk of associated complications. Control of postoperative pain following abdominoplasty remains challenging and may lead to significant morbidity if left untreated. A wide variety of regional techniques, including neuraxial and peripheral nerve blocks, exists. Thoracic epidural analgesia appears to have excellent analgesic effects with additive advantages of reduced postoperative pulmonary complications. However, obvious contraindications, associated risks of hypotension and enhanced recovery after surgery (ERAS) protocols may not make it the standard of care. Ultrasound-guided truncal blocks, on the other hand, do not have the same risk profile and therefore are swiftly gaining favor. Transversus abdominis plane and rectus sheath block have shown success in these cases. Paravertebral nerve block, quadratus lumborum block, and newer paraspinal blocks appear promising due to paravertebral spread and recently identified fascial plane communications. Research is scarce and currently ongoing regarding which regional block is better for lipoabdominoplasty and similar surgeries. Until then, thoracic epidural anesthesia, transversus abdominis, and rectus sheath block are the most commonly used for analgesia in major upper abdominal surgery like lipoabdominoplasty.
Anesthesia for Anorectal Surgery
Authors: Imbelloni Luiz Eduardo , De Aguilar-Nascimento José Eduardo , Chu Iris , Said Engy T. , Nada Eman 
Published: April 2023

Abstract
Anorectal surgeries are common procedures that are typically performed as ambulatory surgery. The success of ambulatory surgery depends largely on a safe and efficient anesthetic technique. Well-placed local anesthesia in the anal canal with sedation can be cost-effective and can improve efficiency. Modification of the spinal anesthesia dose and techniques can provide suitable surgical anesthesia and postoperative analgesia. Modifications include spinal anesthesia with low-dose local anesthetics, saddle-block technique, and posterior hypobaric anesthesia. Transient neurologic syndrome can develop after spinal anesthesia with short-acting local anesthetics; however, with some modifications, the syndrome can be largely avoidable. Postoperative pain after anorectal surgery is very intense, especially at the onset of the first postoperative defecation. Caudal block provides the added benefit of prolonged postoperative analgesia. Bilateral pudendal nerve block provides excellent analgesia without urinary retention. Local infiltration using liposomal bupivacaine after anorectal surgery is effective and safe, and provides prolonged analgesia with opioid-sparing effects. The optimal anesthetic technique would provide excellent operating conditions, a rapid recovery, no postoperative side effects, and high patient satisfaction.
Inadequate Labor Epidural Analgesia
Authors: Ibrahim Mohamed , Vadhera Rakesh 
Published: April 2023

Abstract
Epidural analgesia is the most common method used to control labor pain. However, it has a failure rate of 8%–12%. For that reason, anesthesiologists need to be familiar with the different etiologies that may contribute to the failure of achieving adequate analgesia. These factors include, e.g., unilateral epidural analgesic coverage, epidural space anatomical barriers, and sacral sparing and catheter malposition. Methods and techniques to troubleshoot and improve the success of epidural analgesia are available. Combined spinal epidural (CSE) and dural puncture epidural (DPE) have been successfully used over the years, providing better labor analgesia compared to the traditional labor epidural technique. However, concerns over possible maternal and fetal complications have been studied. Over the last decade, the programmed intermittent epidural (PIEB) regimen has become more popular for maintaining labor analgesia. Meanwhile, some experts have voiced concerns regarding its efficiency, the associated motor block, and the logistics needed for pump programming and education for anesthesia and nursing team members.
Regional Anesthesia Techniques for Circumcision and Congenital Inguinal Hernia Repair
Authors: Webb Leah Margalit Winters , Peterson Melissa Brooks 
Published: April 2023

Abstract
This chapter reviews the anesthetic and analgesic options and implications for two common pediatric procedures: herniorrhaphy and circumcision in former preterm patients. Several regional techniques are available for circumcision including the penile, pudendal nerve, ring blocks and topical anesthesia. For the hernia repair caudal analgesia, ilioinguinal/iliohypogastric nerve block, or field block are options. These techniques are reviewed, including block performance, safety, and risks/benefits. Local anesthetic systemic toxicity in pediatrics will be discussed. The chapter will also discuss disruptive behavior in the operating room. Management of disruptive behavior will be touched on as well.
Regional Anesthesia for Major Abdominal Surgery in Pediatric Patients
Authors: Lazar Alina 
Published: April 2023

Abstract
Major abdominal surgery in children is optimally managed with a multimodal approach with the goals of reducing opioid use and its associated side effects, providing high-quality analgesia, and promoting faster recovery. Multimodal anesthesia includes some form of regional anesthetic block, either central neuraxial or truncal, wound infiltration, pharmacological interventions, and non-pharmacological techniques. Although for many providers epidural analgesia remains the gold standard, its potential for devastating complications remains a concern. Development of new and accessible nerve blocks and improved ultrasound technology has increased the focus on non-neuraxial regional anesthesia techniques in pediatrics. Recent large registries have confirmed the safety of regional anesthesia in children, but more research is needed to determine the mechanisms of action, effectiveness, and safety profile of the newer regional anesthesia techniques.
Surgery in the Presence of Active Addiction or Medication Assisted Addiction Treatment
Authors: Batta Neil , Elkassabany Nabil , Badiola Ignacio 
Published: April 2023

Abstract
The opioid epidemic has proved challenging for pain physicians and the entire healthcare industry. Opioid therapy has been a cornerstone of a multimodal approach to the management of chronic and acute pain. The number of individuals using—and misusing—opioids has also risen in the United States. It is estimated that 5–8 million Americans take daily opioids to treat chronic pain. In 2015 an estimated 20.5 million Americans older than 12 years of age had a substance use disorder, including 2 million to prescription analgesics and heroin. These individuals present to the hospital, for both surgical and non-surgical care, with acute pain that may be very difficult to treat due to opioid tolerance and opioid-induced hyperalgesia. Buprenorphine adds another layer of complexity as it intrinsically blocks full opioid agonists from exerting an effect. Some patients may be on buprenorphine/naloxone and related medications that decrease the effectiveness of opioids in pain management. Other patients on maintenance therapy may wish to avoid exposure to opioids for fear of relapse. Ultimately, poor pain management may result in increased suffering, delayed discharge, decreased patient satisfaction, and increased risk of developing persistent post-surgical pain.
Young Adult Responses to Peer Crowd-Based Targeting in E-cigarette Advertisements: An Experimental Study
Authors: Kim Minji , Neilands Torsten B , Gregorich Steven E , Jordan Jeffrey W , Ling Pamela M 
Published: April 2023

Abstract

Aims
To examine the effects of psychographically targeted e-cigarette advertisements on young adults.

Methods
A total of 2100 young adults (18–29 years old) representing five peer crowds (groups with shared values, interests, and lifestyle: Mainstream, Young Professional, Hip Hop, Hipster, and Partier) were recruited from a nationwide opt-in online panel. Participants were randomly assigned to view e-cigarette advertisements featuring characters that either did or did not match their own peer crowd affiliation and evaluated advertising effectiveness using Likert-type and semantic differential scales. Participants also reported their attitudes toward using e-cigarettes.

Results
No significant overall effect of peer crowd matching was observed. However, significant two-way interaction effects emerged where matching advertisements yielded higher evaluations than mismatching advertisements among those who currently do not use tobacco and nicotine products and among Mainstream participants. Advertisements featuring Mainstream characters were in general rated more highly than other advertisements. Additional analyses found significant effects of peer crowd matching among those who viewed advertisements featuring non-Mainstream characters.

Conclusions
Peer crowd-based targeting can increase the effectiveness of e-cigarette advertisements which may impact initiation among current nonusers, requiring stricter marketing regulations. More research is needed to determine if anti-tobacco messaging tailored by peer crowds may effectively counteract targeted e-cigarette marketing.

Implications
E-cigarette advertisements often use psychographic targeting strategies, using lifestyles, attitudes, and values. Low-risk young adults (eg, those who currently do not use tobacco and nicotine products) are susceptible to psychographically targeted e-cigarette advertisements. This may result in the initiation of e-cigarette use among young adults who would otherwise be less likely to use tobacco and nicotine products. Stricter marketing regulations for emerging tobacco and nicotine products are required to reduce marketing exposure.
Counting Like a State: The Politics of Intergovernmental Partnerships in the 2020 Census
Authors: Rocco Philip 
Published: April 2023

Abstract
State and local officials played an almost unprecedented role in the implementation of the 2020 census. Given a variety of fiscal and political challenges, subnational governments collectively invested billions of dollars to motivate participation in the count, especially among historically undercounted populations. Nevertheless, state and local investments in the census varied substantially. This article examines the roots of variation in state and local census investments, drawing on a set of 76 interviews with public officials and nonprofit leaders, as well as quantitative analyses of state and local decisions. The results indicate that census investments depend on the salience of the 2020 count to public officials, the partisan identities and incentives of governing coalitions, and the availability of subnational institutional capacity for census operations. These findings have important implications for how we think about the role of intergovernmental relations in supporting critical governance tasks in an increasingly turbulent institutional context.
A neglected among the neglected: a review of cutaneous leishmaniasis in Guatemala
Authors: Lopez Yaimie , Arana Byron , Rizzo Nidia , Duran Erick , Acosta-Serrano Álvaro , Mendizabal-Cabrera Renata 
Published: April 2023

ABSTRACT
Cutaneous leishmaniasis (CL) is a parasitic vector-borne disease affecting mostly low- and middle-income countries. CL is endemic in Guatemala, where an increase in the number of cases and incidence and a changing disease distribution in the past decade have been reported. Important research was conducted in Guatemala in the 1980s and 1990s to understand the epidemiology of CL and two Leishmania species were identified as the aetiologic agents. Several species of sand flies have been reported, five of which are naturally infected with Leishmania. Clinical trials conducted in the country evaluated different treatments against the disease and provided solid evidence for CL control strategies that are applicable worldwide. More recently, in the 2000s and 2010s, qualitative surveys were conducted to understand community perceptions of the disease and to highlight the challenges and enablers for disease control. However, limited recent data have been generated regarding the current CL situation in Guatemala, and key information necessary for effective disease control, such as incrimination of vectors and reservoirs, is still lacking. This review describes the current state of knowledge of CL in Guatemala, including the main parasite and sand fly species, disease reservoirs, diagnosis and control, as well as the perceptions of communities in endemic regions.
Monosodium urate crystals alter the circadian clock in macrophages leading to loss of NLRP3 inflammasome repression: Implications for timing of the gout flare
Authors: Popov Dmitry , Jain Lekha , Alhilali Mariam , Dalbeth Nicola , Poulsen Raewyn C. 
Published: April 2023

AbstractGout is caused by monosodium urate (MSU) crystal deposition within joints. This leads to acute episodes of inflammation (“gout flares”) driven by NLRP3 inflammasome activation in macrophages. Gout flares are frequently present during late night/early morning. The reason for this timing is unclear. Recent evidence suggests the NLRP3 inflammasome is under circadian control. The purpose of this study was to determine whether MSU crystals cause changes in the circadian clock in macrophages leading to time‐of‐day differences in NLRP3 inflammasome activation. Levels of circadian clock components were measured in undifferentiated “monocytic” and PMA‐differentiated “macrophagic” THP‐1 cells cultured with/without MSU crystals. Caspase‐1 activity was measured to assess NLRP3 inflammasome activity. MSU crystal exposure resulted in minimal effects on clock genes in THP‐1 monocytes but BMAL1, CRY1, PER2, and REV‐ERBα showed altered expression with reduced protein levels of BMAL1 and REV‐ERBα in THP‐1 macrophages. REV‐ERBα activation or BMAL1 over‐expression resulted in reduced MSU crystal‐induced caspase‐1 activity. BMAL1 knockdown resulted in a further increase in MSU crystal‐induced caspase‐1 activity, but only at times of day when BMAL1 levels were naturally high. MSU crystal‐induced NLRP3 inflammasome activation was greatest at the time of day when BMAL1 levels were naturally low. MSU crystals alter the expression of circadian clock components in THP‐1 macrophages leading to loss of BMAL1 and REV‐ERBα‐mediated repression of NLRP3 inflammasome activity and time‐of‐day differences in susceptibility to inflammasome activation. Our findings suggest that the nocturnal risk of gout flare is at least partially a consequence of altered circadian control of immune cell function.
Tgr5 −/− mice are protected from ethanol-induced metabolic alterations through enhanced leptin and Fgf21 signaling
Authors: Pokhrel Sabita , Dilts Matthew , Stahl Zachary , Boehme Shannon , Frame Gabrielle , Chiang John Y.L. , Ferrell Jessica M. 
Published: April 2023

Background:
Alcohol-associated liver disease (ALD) is caused by chronic use of alcohol and ranges from hepatic steatosis to fibrosis and cirrhosis. Bile acids are physiological detergents that also regulate hepatic glucose and lipid homeostasis by binding to several receptors. One such receptor, Takeda G protein–coupled receptor 5 (TGR5), may represent a therapeutic target for ALD. Here, we used a chronic 10-day + binge ethanol-feeding model in mice to study the role of TGR5 in alcohol-induced liver injury.

Methods:
Female C57BL/6J wild-type mice and Tgr5
−/− mice were pair-fed Lieber-DeCarli liquid diet with ethanol (5% v/v) or isocaloric control diet for 10 days followed by a gavage of 5% ethanol or isocaloric maltose control, respectively, to represent a binge-drinking episode. Tissues were harvested 9 hours following the binge, and metabolic phenotypes were characterized through examination of liver, adipose, and brain mechanistic pathways.

Results:

Tgr5
−/− mice were protected from alcohol-induced accumulation of hepatic triglycerides. Interestingly, liver and serum levels of Fgf21 were significantly increased during ethanol feeding in Tgr5
−/− mice, as was phosphorylation of Stat3. Parallel to Fgf21 levels, increased leptin gene expression in white adipose tissue and increased leptin receptor in liver were detected in Tgr5

−/−
mice fed ethanol diet. Adipocyte lipase gene expression was significantly increased in Tgr5
−/− mice regardless of diet, whereas adipose browning markers were also increased in ethanol-fed Tgr5
−/− mice, indicating potential for enhanced white adipose metabolism. Lastly, hypothalamic mRNA targets of leptin, involved in the regulation of food intake, were significantly increased in Tgr5

−/−
mice fed ethanol diet.

Conclusions:

Tgr5
−/− mice are protected from ethanol-induced liver damage and lipid accumulation. Alterations in lipid uptake and Fgf21 signaling, and enhanced metabolic activity of white adipose tissue, may mediate these effects.
Psychiatric disorders, personality traits, and childhood traumatic events predicting incidence and persistence of chronic pain: results from the CoLaus|PsyCoLaus study
Authors: Rouch Isabelle , Strippoli Marie-Pierre F. , Dorey Jean-Michel , Ranjbar Setareh , Laurent Bernard , von Gunten Armin , Preisig Martin 
Published: April 2023

Abstract
Chronic pain (CP) is often accompanied by mental disorders (MDs). However, little is known concerning the long-term effect of MDs, personality traits, and early-life traumatic events (ETEs) on CP course. Accordingly, we aimed to prospectively assess the associations of major depressive disorders (MDDs), anxiety disorders, personality traits, and ETEs with the incidence and the persistence of CP in middle-aged and older community dwellers. Data stemmed from the 3 first follow-up evaluations of CoLaus|PsyCoLaus, a prospective cohort conducted in the general population of Lausanne (Switzerland). Diagnostic criteria for MDs and ETEs were elicited using semistructured interviews. CP and personality traits were assessed by self-rating questionnaires. Follow-up intervals were subdivided into 2 groups: those without (n = 2280) and those with (n = 1841) CP initially. The associations between the psychological variables and the occurrence or persistence of CP 5 years later were assessed using serially adjusted logistic regression models. Higher neuroticism (odds ratio [95% confidence interval] 1.21 [1.08; 1.36]) and extraversion (1.18 [1.06; 1.32]) were associated with higher 5-year CP incidence, whereas current (2.14 [1.34; 3.44]) and remitted MDD (1.29 [1.00; 1.66]) as well as lower extraversion (0.83 [0.74; 0.94]) were associated with persistence of CP. By contrast, ETEs and anxiety disorders were not associated with the incidence or persistence of CP. Our results suggest that personality traits are associated with both CP occurrence and persistence, whereas the MDDs may be more associated with CP persistence. Both personality and MDD are accessible to psychotherapy, and MDD is also accessible to pharmacotherapy. Hence, these therapeutic measures might decrease the risk of CP and its persistence.
Coronary artery calcium progression and all-cause mortality
Authors: Eghtedari Bibinaz , Kinninger April , Roy Sion K. , Budoff Matthew J. 
Published: April 2023

Background
Coronary artery calcium (CAC) has been demonstrated as a noninvasive, low-cost means of assessing atherosclerotic burden and risk of major cardiovascular events. While it has been previously shown that CAC progression predicts all-cause mortality, we sought to quantify this association by examining a large cohort over a follow-up period of 1–22 years.

Methods
We studied 3260 persons aged 30–89 years referred by their primary physician for CAC measurement, with a follow-up scan at least 12 months from the initial scan. Receiver operator characteristic (ROC) curves assessed a level of annualized CAC progression that predicted all-cause mortality. Multivariate analyses using Cox proportional hazards models were used to compute hazard ratios and 95% confidence intervals (CIs) for the association between annualized CAC progression and death after adjusting for relevant cardiovascular risk factors.

Results
The average time between scans was 4.7 ± 3.2 years with an additional average of 9.1 ± 4.0 years of follow-up time. The average age of the cohort was 58.1 ± 10.5 years, 70% being male, and 164 deaths occurred. Annualized CAC progression of 20 units optimized sensitivity (58%) and specificity (82%) in ROC curve analysis. Annualized CAC progression of 20 units was significantly associated with mortality while adjusting for age, sex, race, diabetes, hypertension, hyperlipidemia, smoking, baseline CAC level, family history, and time between scans, hazard ratio 1.84 (95% CI, 1.28–2.64) P = 0.001.

Conclusion
Annualized CAC progression of greater than 20 units per year significantly predicts all-cause mortality. This may add clinical value in encouraging close surveillance and aggressive treatment of individuals within this range.