Impact of Locum Tenens Providers on Delivery of Pediatric Surgical Care.

Introduction: We sought to understand the impact of locum tenens surgeons on pediatric surgical care delivery.

Methods: We conducted a cross-sectional survey of Children's Hospital Association pediatric surgical practices. Anonymous electronic surveys were used to investigate locum tenens utilization, primary reason for use, limitations on clinical activities, and variations in practice standards or quality.

Delayed-Onset Arterial Gas Embolism After Underwater Egress Training.

Background: Arterial gas embolism (AGE) may occur while breathing compressed air and failing to exhale during ascent to compensate for gas expansion as pressure decreases. Trauma to the lungs from over-pressurization may result in air bubbles entering the pulmonary veins and subsequently the systemic circulation, causing obstructed blood flow and inflammatory cascades. AGEs are known to always manifest within 10 min of surfacing from depth.

Outcomes in Neonates Receiving Therapeutic Hypothermia and Extracorporeal Membrane Oxygenation versus Extracorporeal Membrane Oxygenation Alone.

Objective:  This study aimed to examine survival and outcomes in neonates who received therapeutic hypothermia (TH) for neonatal encephalopathy (NE) and extracorporeal membrane oxygenation (ECMO) versus ECMO alone.

Study Design:  This is a retrospective review of Extracorporeal Life Support Organization (ELSO) Registry data from 2007 to 2017 for neonates undergoing ECMO and TH for NE (TH/ECMO) or ECMO alone. Primary outcomes were ECMO survival and survival to discharge.

Efficacy of a prototype ventilated vest in mitigating physiological and cognitive impairments during simulated military tasks in hot environments.

Many occupations, including military and industrial, cannot benefit from large-scale cooling strategies; therefore, personal cooling strategies may be more appropriate. We assessed the efficacy of a ventilated vest (Vest) based on participant' autonomic and cognitive responses during military-related activities in the heat. Male soldiers conducted 90-min trials in 35 °C ambient temperature and 40% relative humidity: i) March with/without Vest (N = 10), ii) Guard duty with/without Vest (N = 8).

Malignancy risk associated with radioactive iodine therapy for Graves' disease.

Background: Radioactive iodine therapy (RAI) is a frequently chosen therapy for Graves' disease. The aim of this study was to determine whether RAI for Graves' disease increases the risk of thyroid malignancy.

Methods: A retrospective analysis was performed of all Graves' disease patients who underwent thyroidectomy at a single institution between 2013 and 2022.

Common variants increase risk for congenital diaphragmatic hernia within the context of de novo variants.

Congenital diaphragmatic hernia (CDH) is a severe congenital anomaly often accompanied by other structural anomalies and/or neurobehavioral manifestations. Rare de novo protein-coding variants and copy-number variations contribute to CDH in the population. However, most individuals with CDH remain genetically undiagnosed.

Aortic Dissection in a Neonate Receiving Extracorporeal Life Support Therapy: A Case Report.

Extracorporeal life support (ECLS) therapy is increasingly being used to support children with refractory cardiorespiratory failure, but its use is occasionally associated with complications.1 Neonatal aortic dissection in association with ECLS is rare and the clinical sequelae of aortic dissection in neonates are poorly understood. We report a case of extensive type B aortic dissection in a neonate receiving ECLS therapy for refractory cardiogenic shock secondary to tachycardia-induced cardiomyopathy and Wolf Parkinson White (WPW) syndrome.

The combined effects of temperature and posture on regional blood flow and haemodynamics.

Under simultaneous ambient temperature and postural stressors, integrated regional blood flow responses are required to maintain blood pressure and thermoregulatory homeostasis. The aim of the present study was to assess the effect of ambient temperature and body posture on regional regulation of microvascular blood flow, specifically in the arms and legs. Participants (N = 11) attended two sessions in which they experienced transient ambient conditions, in a climatic chamber.

Validation of formulae predicting stroke volume from arterial pressure: with particular emphasis on upright individuals in hot ambient conditions.

Introduction: During heatwaves, it is important to monitor workers' cardiovascular health since 35% of those working in hot environments experience symptoms of heat strain. Wearable technology has been popularized for monitoring heart rate (HR) during recreational activities, but it can also be used to monitor occupational heat strain based on core and skin temperatures and HR. To our knowledge, no devices estimate the cardiovascular strain directly based on stroke volume (SV) or cardiac output (CO).

Early Findings of a Preterm Twin Cohort Study Examining the Effect of General Anesthesia on Developmental Outcomes.

Purpose: The premature infant brain may be particularly vulnerable to anesthesia effects, but there is conflicting evidence on the association between anesthesia exposure and developmental outcomes. Twin studies can control for confounding factors. A twin cohort of premature twins provides internal control of difficulty to measure confounders and delivers added power to a study examining the effects of anesthesia on neurodevelopmental outcomes.

Disturbance-mediated changes to boreal mammal spatial networks in industrializing landscapes.

Compound effects of anthropogenic disturbances on wildlife emerge through a complex network of direct responses and species interactions. Land-use changes driven by energy and forestry industries are known to disrupt predator-prey dynamics in boreal ecosystems, yet how these disturbance effects propagate across mammal communities remains uncertain. Using structural equation modeling, we tested disturbance-mediated pathways governing the spatial structure of multipredator multiprey boreal mammal networks across a landscape-scale disturbance gradient within Canada's Athabasca oil sands region.

Native prey, not landscape change or novel prey, drive cougar () distribution at a boreal forest range edge.

Many large carnivores, despite widespread habitat alteration, are rebounding in parts of their former ranges after decades of persecution and exploitation. Cougars () are apex predator with their remaining northern core range constricted to mountain landscapes and areas of western North America; however, cougar populations have recently started rebounding in several locations across North America, including northward in boreal forest landscapes. A camera-trap survey of multiple landscapes across Alberta, Canada, delineated a range edge; within this region, we deployed an array of 47 camera traps in a random stratified design across a landscape spanning a gradient of anthropogenic development relative to the predicted expansion front.

Incidental Ga-DOTATATE uptake in thyroid nodules: Is guideline-directed management still appropriate?

Background: Fluorodeoxyglucose uptake on positron emission tomography imaging has been shown to be an independent risk factor for malignancy in thyroid nodules. More recently, a new positron emission tomography radiotracer-Gallium-68 DOTATATE-has gained popularity as a sensitive method to detect neuroendocrine tumors. With greater availability of this imaging, incidental Gallium-68 DOTATATE uptake in the thyroid gland has increased.

Mammal responses to global changes in human activity vary by trophic group and landscape.

Wildlife must adapt to human presence to survive in the Anthropocene, so it is critical to understand species responses to humans in different contexts. We used camera trapping as a lens to view mammal responses to changes in human activity during the COVID-19 pandemic. Across 163 species sampled in 102 projects around the world, changes in the amount and timing of animal activity varied widely.

How landscape traits affect boreal mammal responses to anthropogenic disturbance.

Understanding mammalian responses to anthropogenic disturbance is challenging, as ecological processes and the patterns arising therefrom notoriously change across spatial and temporal scales, and among different landscape contexts. Responses to local scale disturbances are likely influenced by landscape context (e.g.

Mammalian predator and prey responses to recreation and land use across multiple scales provide limited support for the human shield hypothesis.

Outdoor recreation is widespread, with uncertain effects on wildlife. The human shield hypothesis (HSH) suggests that recreation could have differential effects on predators and prey, with predator avoidance of humans creating a spatial refuge 'shielding' prey from people. The generality of the HSH remains to be tested across larger scales, wherein human shielding may prove generalizable, or diminish with variability in ecological contexts.

Stability Study and Handling Recommendations for Multiresidue Pesticide Mixes under Diverse Storage Conditions for LC-MS/MS and GC-MS/MS.

Background: In response to the growing global need for pesticide residue testing, laboratories must develop versatile analytical methods and workflows to produce scientifically sound results. One of the many challenges faced by food chemists is acquiring suitable pesticide certified reference materials (CRMs) to calibrate analytical equipment, monitor method performance, and confirm the identity and concentration of hundreds of pesticide residues in food samples. CRM producers invest considerable resources to ensure the stability of their products.

A Novel Risk Score to Predict Hungry Bone Syndrome After Parathyroidectomy for Renal Hyperparathyroidism.

Objective: Hungry bone syndrome (HBS) is a known complication of parathyroidectomy. Patients with renal hyperparathyroidism are particularly vulnerable to HBS because of their prolonged exposure to electrolyte abnormalities and elevated parathyroid hormone (PTH). However, in-depth characterization of predictive factors for HBS in these patients is lacking.

Influence of heterospecifics on mesocarnivore behaviour at shared scavenging opportunities in the Canadian Rocky Mountains.

In seasonal environments, the ability of mustelid species to acquire carrion-a dietary resource heavily depended upon-is driven by a collection local habitat characteristics and competition dynamics. In resource-scarce winter, sympatric mesocarnivores must balance energetic rewards of carrion with avoiding antagonistic interactions with conspecifics. We examined scavenging interactions among three mustelid species in the northern Canadian Rocky Mountains.

Industrial development alters wolf spatial distribution mediated by prey availability.

Increasing resource extraction and human activity are reshaping species' spatial distributions in human-altered landscape and consequently shaping the dynamics of interspecific interactions, such as between predators and prey. To evaluate the effects of industrial features and human activity on the occurrence of wolves (), we used wildlife detection data collected in 2014 from an array of 122 remote wildlife camera traps in Alberta's Rocky Mountains and foothills near Hinton, Canada. Using generalized linear models, we compared the occurrence frequency of wolves at camera sites to natural land cover, industrial disturbance (forestry and oil/gas exploration), human activity (motorized and non-motorized), and prey availability (moose, ; elk, ; mule deer, ; and white-tailed deer, ).