Microaggressions in Clinical Medicine.

This paper proposes a victim-centered account of microaggressions within the context of clinical medicine. In so doing, it argues that microaggressions can undermine physician-patient relationships, preclude relationships of trust, and therefore compromise the kind and quality of care that patients deserve. Ultimately, by focusing on the experiences of victims of microaggressions, the paper demonstrates how harmful microaggressions in clinical medical contexts can be, and thus provides strong reasons why healthcare providers ought to know about them and actively work to avoid committing them.

Isolation of Cyclic(Alkyl)(Amino) Carbene-Bismuthinidene Mediated by a Beryllium(0) Complex.

The long-sought carbene-bismuthinidene, (CAAC)Bi(Ph), has been synthesized. Notably, this represents both the first example of a carbene-stabilized subvalent bismuth complex and the extension of the carbene-pnictinidene concept to a non-toxic metallic element (Bi). The bonding has been investigated by single-crystal X-ray diffraction studies and DFT calculations.

Comparison of computed tomographic attenuation values for epaxial muscles in old and young dogs.

OBJECTIVE To determine whether the degree of CT attenuation of muscle would differ between healthy old and young dogs. ANIMALS 10 healthy old (> 8 years old) and 9 healthy young (1 to 5 years old) Labrador Retrievers with a body condition score of 5 or 6 on a 9-point scale. PROCEDURES CT was performed with the dogs mildly sedated.

High Pesticide Exposure Events and Olfactory Impairment among U.S. Farmers.

Background: Olfactory impairment (OI) is common among older adults and independently predicts all-cause mortality and the risk of several major neurodegenerative diseases. Pesticide exposure may impair olfaction, but empirical evidence is lacking.

Objective: We aimed to examine high pesticide exposure events (HPEEs) in relation to self-reported OI in participants in the Agricultural Health Study (AHS).

Poverty: Not a Justification for Banning Physician-Assisted Death.

Many critics of the legalization of physician-assisted death oppose it in part because they fear it will further disadvantage those who are already economically disadvantaged. This argument points to a serious problem of how economic considerations can influence medical decisions, but in the context of PAD, the concern is not borne out. We will provide empirical evidence suggesting that concerns about money influence medical decisions throughout the full course of illness, but at the end of life, financial pressure is much more likely to influence a decision to pursue or reject aggressive life-extending care than it is to influence a request for PAD.

Multidisciplinary Authorship Among Infectious Diseases Society of America Clinical Practice Guidelines: Examining the Contributions of Infectious Diseases Pharmacists.

We describe the proportion of pharmacist representation among current and corresponding prior editions of Infectious Diseases Society of America (IDSA) clinical practice guidelines (CPGs). Pharmacist representation was 13% and 21% in previous and current editions, respectively, increasing significantly since 2011. We advocate for continued collaborations between IDSA and pharmacy organizations to enhance multidisciplinary representation in CPGs.

Acquired cystic fibrosis transmembrane conductance regulator dysfunction.

Sinonasal respiratory epithelium is a highly regulated barrier that employs mucociliary clearance (MCC) as the airways first line of defense. The biological properties of the airway surface liquid (ASL), combined with coordinated ciliary beating, are critical components of the mucociliary apparatus. The ASL volume and viscosity is modulated, in part, by the cystic fibrosis transmembrane conductance regulator (CFTR).

A pilot study investigating circulating trimethylamine N-oxide and its precursors in dogs with degenerative mitral valve disease with or without congestive heart failure.

Background: Pathophysiologic mechanisms for the development and progression of degenerative mitral valve disease (DMVD) remain elusive. Increased concentrations of circulating trimethylamine N-oxide (TMAO) and its precursors choline and l-carnitine are associated with the presence and severity of heart disease in people.

Objectives: To determine if differences exist in plasma concentrations of TMAO, choline, or l-carnitine among dogs with DMVD and congestive heart failure (CHF), dogs with asymptomatic DMVD, and healthy control dogs.

Molecular basis for activation of lecithin:cholesterol acyltransferase by a compound that increases HDL cholesterol.

Lecithin:cholesterol acyltransferase (LCAT) and LCAT-activating compounds are being investigated as treatments for coronary heart disease (CHD) and familial LCAT deficiency (FLD). Herein we report the crystal structure of human LCAT in complex with a potent piperidinylpyrazolopyridine activator and an acyl intermediate-like inhibitor, revealing LCAT in an active conformation. Unlike other LCAT activators, the piperidinylpyrazolopyridine activator binds exclusively to the membrane-binding domain (MBD).

Exploring the relationship between Endothelin-1 and peripheral inflammation in multiple sclerosis.

Background: Identifying pathways linking neuroinflammation and neurodegeneration is essential to help prevent disability progression in people with multiple sclerosis (MS). Endothelin-1 (ET-1) is a potent vasoconstrictor thought to contribute to cerebral hypoperfusion and tissue damage in MS. Its link with the neuroinflammatory process remains poorly investigated.

Activity Tracking with Momentary Assessments.

Task and activity tracking has been an effective industrial management and research technique for generations. It is applied to workflow optimization, group coordination, task sequencing, individual time management and environmental exposures. Appropriately, task tracking technologies are migrating to personal mobile devices.

Evaluation of a quantitatively derived value for assessment of muscle mass in clinically normal cats.

OBJECTIVE To evaluate use of an ultrasonographically and radiographically determined value, the vertebral epaxial muscle score (VEMS), for assessing muscle mass in cats. ANIMALS 30 healthy neutered cats of various body weights and between 1 and 6 years of age. PROCEDURES Mean epaxial muscle height was calculated from 3 transverse ultrasonographic images obtained at the level of T13.

Sex Categorization in Medical Contexts: A Cautionary Tale.

The goal of this paper is to problematize the use of sex categories in medical contexts. We question the benefits of categorizing all individuals as either male or female in medical contexts and argue that we should focus instead on the relevant sex-related properties of patients. Contrary to what many people believe, the classificatory system by which sexed bodies are neatly divided into male and female is anything but clear.

An economic analysis of patient controlled remifentanil and epidural analgesia as pain relief in labour (RAVEL trial); a randomised controlled trial.

Objective: To compare the costs of a strategy of patient controlled remifentanil versus epidural analgesia for pain relief in labour.

Design: We performed a multicentre randomised controlled trial in 15 hospitals in the Netherlands, the RAVEL trial. Costs were analysed from a health care perspective alongside the RAVEL trial.

Photosynthesis by marine algae produces sound, contributing to the daytime soundscape on coral reefs.

We have observed that marine macroalgae produce sound during photosynthesis. The resultant soundscapes correlate with benthic macroalgal cover across shallow Hawaiian coral reefs during the day, despite the presence of other biological noise. Likely ubiquitous but previously overlooked, this source of ambient biological noise in the coastal ocean is driven by local supersaturation of oxygen near the surface of macroalgal filaments, and the resultant formation and release of oxygen-containing bubbles into the water column.

Borderline personality disorder and substance use disorders: an updated review.

For decades, clinicians and researchers have recognized that borderline personality disorder (BPD) and substance use disorders (SUDs) are often diagnosed within the same person (e.g., (Gunderson JG.

Activation of medial hypothalamic orexin neurons during a Go/No-Go task.

Orexin neurons (Orx; also referred to as hypocretin) are found exclusively in the hypothalamus, and release the neuropeptides orexin A and orexin B (also referred to as hypocretin 1 and 2) throughout the CNS. With its widespread targets, the orexin system is involved in a number of functions including, but not limited to stress, reward, wakefulness, and food seeking. Our laboratory has previously proposed that the dorsomedial hypothalamus (DMH) and perifornical (PFA) orexin neurons function in stress and arousal whereas those in lateral hypothalamus (LH) participate in reward processes (Harris and Aston-Jones, 2006).