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Ellegaard Stephenson posted an update 6 months, 2 weeks ago
Background Given the importance of operative documentation, we reviewed operative notes for surgeries that required splenic flexure mobilization (SFM) to determine their accuracy. Materials and Methods We performed a retrospective review of 51 operative notes for complete SFMs performed at a single institution from January 2015 to June 2020. Results None of the operative notes reported a rationale for performing SFM, use of preoperative imaging to guide technical approach, reasoning for the operative method and mobilization approach used, or specific steps taken to ensure that SFM was done safely. Most reports did not include technical details, with one-third of the notes merely reporting that “the splenic flexure was mobilized.” Conclusions Increased awareness about the lack of operative documentation of the critical aspects of the SFM could stimulate initiatives to standardize the SFM method and improve the quality of operative notes for SFM.A profile mixture (PM) model is a model of protein evolution, describing sequence data in which sites are assumed to follow many related substitution processes on a single evolutionary tree. The processes depend, in part, on different amino acid distributions, or profiles, varying over sites in aligned sequences. A fundamental question for any stochastic model, which must be answered positively to justify model-based inference, is whether the parameters are identifiable from the probability distribution they determine. Here, using algebraic methods, we show that a PM model has identifiable parameters under circumstances in which it is likely to be used for empirical analyses. In particular, for a tree relating 9 or more taxa, both the tree topology and all numerical parameters are generically identifiable when the number of profiles is less than 74.Introduction The World Health Organization recommends 6 months of exclusive breastfeeding for infants. Racial disparities exist, where only 27.9% of black women exclusively breastfeed at 6 months compared to 45.1% of white mothers. Previous research suggests that these disparities are due to a variety of factors, including poor paid leave policies, racism, and bias, but few studies have looked specifically at the experience of black millennial mothers. Methods This qualitative study aimed to understand the racialized experiences of breastfeeding among black millennials and whether or not there are factors to mitigate the effects of racism. Three focus groups were conducted (N = 15) with black millennial mothers. Participants were recruited through social media sites, emails to breastfeeding/black maternal health organizations, and local partnerships. Inclusion criteria included self-identification as a black/African American woman, born between 1981 and 1996, and having at least one child 5 years or younger. Results Five major themes emerged from the analysis as follows (1) institutional racism and barriers, (2) challenges to motherhood, (3) black experiences, (4) breastfeeding in the millennial age, and (5) hopes for the community. Results showed that black millennial mothers expressed being treated differently and poorly due to race. While participants reported supporting each other through their breastfeeding journey, this was not specifically a strategy to impact racism/bias. Discussion Results also showed that black millennials feel a desire to succeed in breastfeeding to change the narrative about past generations. Further research should explore differences between the breastfeeding experiences and perceptions of black millennials in comparison to that of previous generations.Background Infants and young children with high weight-for-length are at increased risk for obesity in later life. This study describes prevalence of high weight-for-length and examines changes during 2010-2018 among 11,366,755 infants and young children 3-23 months of age in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods Children’s weights and lengths were measured. High weight-for-length was defined as ≥2 standard deviations above sex and age-specific median on World Health Organization growth charts. Adjusted prevalence differences (APDs) between years were calculated as 100 times marginal effects from logistic regression models. APD was statistically significant if 95% confidence interval did not include 0. Results Adjusted prevalence of high weight-for-length decreased from 2010 to 2014, and leveled off through 2018 overall, in boys and girls, those 6-11 and 18-23 months of age, and non-Hispanic whites, non-Hispanic blacks, Hispanics, and Asians/Pacific Islanders. For 12-17 months old and American Indian/Alaska Native infants and young children, adjusted prevalence decreased from 2010 to 2014, and then increased slightly through 2018. Among 56 WIC state or territorial agencies, 33 had significant decreases between 2010 and 2018, whereas 8 had significant increases. Between 2014 and 2018, prevalence decreased significantly in 12 agencies and increased significantly in 23. Conclusions The results indicate overall declines in prevalence of high weight-for-length from 2010 to 2018, with a prevalence stabilization since 2014. Continued surveillance is needed. Obesity prevention strategies in WIC and multiple settings are important for ensuring healthy child growth.
Following an unexplained cardiac arrest, clinical genetic testing is increasingly becoming standard of care. JAK inhibitor Periodic review of variant classification is required, as reinterpretation can change the diagnosis, prognosis, and management of patients and their relatives.
This study aimed to develop and validate a standardized algorithm to facilitate clinical application of the 2015 American College of Medical Genetics and Association for Molecular Pathology guidelines for the interpretation of genetic variants. The algorithm was applied to genetic results in the Cardiac Arrest Survivors With Preserved Ejection Fraction Registry, to assess the rate of variant reclassification over time. Variant classifications were then compared with the classifications of 2 commercial laboratories to determine the rate and identify sources of variant interpretation discordance.
Thirty-one percent of participants (40 of 131) had at least 1 genetic variant with a clinically significant reclassification over time. Variants of uncertain significance were more likely to be downgraded (73%) to benign than upgraded to pathogenic (27%;
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