Regional Anesthesia With Pectoral Blocks as a Non-inferior Approach for Mastectomy Analgesia: A Quality Improvement Study.

Introduction Breast cancer is one of the most common female malignancies in the United States and often necessitates surgical interventions that carry a substantial risk of postoperative pain. Pectoral nerve blocks have emerged as a simpler alternative for providing regional perioperative analgesia to the chest wall in breast cancer surgery. This retrospective study evaluated the impact of implementing a novel regional anesthesia protocol centering on the use of pectoral nerve blocks for patients undergoing radical mastectomy at a small regional hospital in Spartanburg, South Carolina.

Translational Bioethical Decision-Making: Human Brain Organoids as a Case Study.

In an earlier essay, I advocated that translational bioethics uses the public's values, determined through social science, in its analysis of translational science technologies. It may be unclear what those values might be, and whether such a translational ethics would necessarily conclude that cutting edge technologies should not be developed. In this essay, I show the public's values relevant to human brain organoids and argue that a translational bioethics analysis using these values would support continued organoid research.

Scientism, trust, value alignment, views of nature, and U.S. public opinion about gene drive mosquitos.

Gene drive could be a powerful tool for addressing problems of conservation, agriculture, and human health caused by insect and animal pests but is likely to be controversial as it involves the release of genetically modified organisms. This study examined the social determinants of opinion of gene drive. We asked a representative sample of the U.

Translational Bioethics and Public Input.

Translational science is justified as advancing the public's interests but has no mechanism for determining these interests. Standard social science approaches would produce either unrepresentative descriptions or a cacophony of data not easily condensed into a concrete conclusion about moving forward with a translational-science project. Here, I propose that the simplifying and structuring ethics employed by institutional review boards (IRBs) be used to create social science reports of the four to six most prominent values or principles of the public regarding a biotechnology.

Neurocheck Frequency: Determining Perceptions and Barriers to Implementation of Evidence-Based Practice.

Background: Following acute brain injury, patients in the intensive care unit often undergo hourly or every-other-hour exams ("neurochecks") to monitor for neurodeterioration. We assessed health care provider attitudes towards neurocheck frequency and evaluated providers' ideal neurocheck frequency.

Methods: This was a cross-sectional, online survey distributed in Spring 2021 at a tertiary care academic medical center.

Brain organoids, consciousness, ethics and moral status.

Advances in the field of human stem cells are often a source of public and ethical controversy. Researchers must frequently balance diverse societal perspectives on questions of morality with the pursuit of medical therapeutics and innovation. Recent developments in brain organoids make this challenge even more acute.

Patient narratives of hope in stem cell technologies: Trust in biomedicine and the body's natural ability to heal itself.

The scholarship on patient hope in biomedical technologies describes two narratives of hope: the biomedical and the individual. The biomedical narrative represents patients' beliefs that the institution of science will eventually produce treatment for their disease, whereas the individual narrative represents patients' beliefs that they can alter their prognosis through affective and behavioral modifications. The distinct analytical categories of "biomedical" and "individual," however, fail to account for the fact that patient hope has been found to be much more complex.

Saccharomyces cerevisiae strains used industrially for bioethanol production.

Fuel ethanol is produced by the yeast Saccharomyces cerevisiae mainly from corn starch in the United States and from sugarcane sucrose in Brazil, which together manufacture ∼85% of a global yearly production of 109.8 million m3 (in 2019). While in North America genetically engineered (GE) strains account for ∼80% of the ethanol produced, including strains that express amylases and are engineered to produce higher ethanol yields; in South America, mostly (>90%) non-GE strains are used in ethanol production, primarily as starters in non-aseptic fermentation systems with cell recycling.

Setting ethical limits on human gene editing after the fall of the somatic/germline barrier.

The ethical debate about what is now called human gene editing (HGE) has gone on for more than 50 y. For nearly that entire time, there has been consensus that a moral divide exists between somatic and germline HGE. Conceptualizing this divide as a barrier on a slippery slope, in this paper, I first describe the slope, what makes it slippery, and describe strong barriers that arrest the slippage down to the dystopian bottom of pervasive eugenic enhancement.

Reactions to the National Academies/Royal Society Report on .

In September 2020, a detailed report on was published. The report offers a translational pathway for the limited approval of germline editing under limited circumstances and assuming various criteria have been met. In this perspective, some three dozen experts from the fields of genome editing, medicine, bioethics, law, and related fields offer their candid reactions to the National Academies/Royal Society report, highlighting areas of support, omissions, disagreements, and priorities moving forward.

Self-Interested and Altruistic Motivations in Volunteering for Clinical Trials: A More Complex Relationship.

Empirical studies have found that altruism and self-interest are the two primary motivations for enrollment in clinical trials. Some studies have shown that in some cases these two motivations are contingent upon each other, which complicates our understanding of motivation. In this study, we interviewed 27 people with Parkinson's disease about their willingness to enroll in a hypothetical clinical trial.

Mechanical Function of the Nucleus Pulposus of the Intervertebral Disc Under High Rates of Loading.

Study Design: Bovine motion segments were used to investigate the high-rate compression response of intervertebral discs (IVD) before and after depressurising the nucleus pulposus (NP) by drilling a hole through the cranial endplate into it.

Objective: To investigate the effect of depressurising the NP on the force-displacement response, and the energy absorption in IVDs when compressed at high strain rates.

Summary Of Background Data: The mechanical function of the gelatinous NP located in the center of the IVDs of the spine is unclear.

Interactive translational research model and cadaveric simulation: where minimally invasive cardiac surgery and industry meet.

Focused research targeting an identified clinical problem may result in more rapid development of medical devices, technologies, and surgical techniques that directly impact patient care. These medical advances to improve patient care may be expedited by adopting an interactive translational research model in which inventors, designers, and engineers work in collaboration with surgeons. In addition, cadaveric simulation is a high-fidelity model that is bridging the translational and logistical gap to bring new surgical devices, technologies, and techniques to patients.

Expanding Access to Clinical Services for Toddlers with Autism Spectrum Disorders.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder typically diagnosed in the toddler and preschool years. Intensive early intervention (EI) using applied behavior analytic procedures is the evidenced-based intervention most effective in improving developmental outcomes. Unfortunately, there are numerous barriers to accessing EI services for toddlers with ASD.

Biomedical ethics and clinical oversight in multisite observational neuroimaging studies with children and adolescents: The ABCD experience.

Observational neuroimaging studies with children and adolescents may identify neurological anomalies and other clinically relevant findings. Planning for the management of this information involves ethical considerations that may influence informed consent, confidentiality, and communication with participants about assessment results. Biomedical ethics principles include respect for autonomy, beneficence, non-maleficence, and justice.

Physician Satisfaction With Integrated Behavioral Health in Pediatric Primary Care.

As the benefits of integrated behavioral health care services are becoming more widely recognized, this study investigated physician satisfaction with ongoing integrated psychology services in pediatric primary care clinics. Data were collected across 5 urban and 6 rural clinics and demonstrated the specific factors that physicians view as assets to having efficient access to a pediatric behavioral health practitioner. Results indicated significant satisfaction related to quality and continuity of care and improved access to services.

Brief educational "curbside consultation": Impact on attention-deficit/hyperactivity disorder referrals in an integrated healthcare setting.

Introduction: As behavioral health providers integrate into primary health care clinics, it is important to examine methods used to increase primary care providers' (PCPs) knowledge of behavioral health providers' areas of expertise and service provision. Attention-deficit/hyperactivity disorder (ADHD) has been identified as one of the most common behavioral health disorders PCPs diagnose and treat in children.

Method: This study examined whether 2 brief educational "curbside consults," during which a psychologist provided information regarding the assessment and treatment of ADHD, had an impact on PCPs' referral practices.

The Munroe-Meyer Approach: Continuous Integration of Didactic Instruction, Research, and Clinical Practice.

Increased demand for applied behavior analysis (ABA) services has increased the need for additional masters-level practitioners and doctoral-level academicians and clinical directors. Based on these needs, the University of Nebraska Medical Center's (UNMC) Munroe-Meyer Institute has developed a PhD program. The academic structure at UNMC allowed us to create our PhD program in a relatively quick and efficient manner.

The HLA-G cycle provides for both NK tolerance and immunity at the maternal-fetal interface.

The interaction of noncytotoxic decidual natural killer cells (dNK) and extravillous trophoblasts (EVT) at the maternal-fetal interface was studied. Confocal microscopy revealed that many dNK interact with a single large EVT. Filamentous projections from EVT enriched in HLA-G were shown to contact dNK, and may represent the initial stage of synapse formation.

Phone Consultation for Behavioral Health-Related Referrals in Integrated Primary Care.

Behavioral health (BH) providers add value to primary care teams. This descriptive study illustrates one such role that the BH provider can serve. The on-site BH provider responded to patient phone inquiries regarding BH topics for pediatricians over the course of 15 months.