"How I"

Imagine being given the immense responsibility and gift as a researcher to deliver a person's final nature experience. People living with severe chronic obstructive pulmonary disease (COPD) are often sheltered from nature experiences due to their disease status; however, they have rich memories of past nature experiences. The goals of this overall journey of co-creation were two-fold: (1) co-create personalized nature-based utilizing immersive 360-degree virtual reality (VR) experiences based on participants' experiences in outdoor spaces; (2) utilize a narrative approach to explore the lived realities of people living with severe COPD...

Anemia is a common problem in pediatrics. The most frequent cause is iron deficiency, but it can also be associated to a constitutional or acquired pathology of the bone marrow or red blood cells. We describe a practical approach for rapidly guiding the diagnosis and management of anemia in children. It is based on the history and clinical examination, mean corpuscular volume, ferritinemia, reticulocytosis and hemolytic profile.

BACKGROUND: Many lesions in the anterior skull base may compress the optic nerve (ON), leading to vision loss, and even irreversible blindness. Although decompression of the optic nerve has traditionally been achieved transcranially, the endoscopic endonasal approach (EEA) is gaining traction as a minimally invasive approach recently. METHOD: We describe the key steps of an EEA ON decompression. The relevant surgical anatomy with illustration is described. Additionally, a video detailing our technique and instruments on an illustrative case is provided...

BACKGROUND: Transvenous embolization of high-grade dural arteriovenous fistulas (dAVFs) is challenging particularly when the direct sinus access is favorable due to the complex venous anatomy which prohibits endovascular access via the transfemoral approach. METHOD: The procedure was conducted in the hybrid operating suite, where a burr hole was performed, followed by direct catheterization of the superior sagittal sinus. Coil embolization was then executed to achieve complete obliteration of the fistula...

BACKGROUND: Online medical education often faces challenges related to communication and comprehension barriers, particularly when the instructional language differs from the healthcare providers' and caregivers' native languages. Our study addresses these challenges within pediatric healthcare by employing generative language models to produce a linguistically tailored, multilingual curriculum that covers the topics of team training, surgical procedures, perioperative care, patient journeys, and educational resources for healthcare providers and caregivers...

Post-thaw cell viability assessment is very important in cryopreservation because it is the main assessment method used to optimize the cryopreservation protocols for each cell type; hence, having standardized accurate, quick, and reliable assays for post-thaw cell viability measurements is of utmost importance. The trypan blue exclusion assay and nucleic-acid-binding fluorescence-based assays are two different methods for cell viability assessment. Both assays identify cells with damaged membranes by whether they let a compound enter the cell...

Pain science education (PSE) provides people with an understanding of "how pain works" grounded in the biopsychosocial model of pain; it has been demonstrated to improve outcomes in musculoskeletal pain conditions. Preliminary evidence suggests PSE may be effective for female individuals with persistent pelvic pain, but how the content of PSE needs to be modified for this group remains to be determined. A reflexive thematic analysis of qualitative data was performed to identify PSE concepts that female individuals with persistent pelvic pain consider important and why...

Recipients of hematopoietic stem cell transplants and solid organ transplants frequently develop pulmonary infiltrates from both infectious and non-infectious etiologies. Differentiation and further characterization of microbiologic etiologies-viral, bacterial, and fungal-can be exceedingly challenging. Pediatric patients face unique challenges as confirmatory evaluations with bronchoscopy or lung biopsy may be limited. A generalizable approach to diagnosing and managing these conditions has not been well established...

In this manuscript, we present our concept for training in robotic surgery of the upper gastrointestinal tract. The training concept presented here focuses on the two surgical "user groups", assistants (table assists) and specialists (surgeons), and presents the core aspects of training for each group separately.For table assistants, we present opportunities for early involvement in robotics and our approach to learning the first steps in preparing for surgery, assisting during surgery, as well as communication as a key factor in robotic surgery and alternative training...

No abstract text is available yet for this article.

When administered as first-line intervention to patients admitted with acute hypercapnic respiratory failure secondary to chronic obstructive pulmonary disease exacerbation in conjunction with guideline recommended therapies, noninvasive ventilation (NIV) has been shown to reduce mortality and endotracheal intubation. Opportunities to increase uptake of NIV continue to exist despite inclusion of this therapy in clinical guidelines. Identifying patients appropriate for NIV, and subsequently providing close monitoring to determine an improvement in clinical condition involves a team consisting of physician, nurse and respiratory therapist in institutions that successfully implement NIV...

No abstract text is available yet for this article.

BACKGROUND: Spinal dural arteriovenous fistula (sDAVF) is a rare vascular malformation that leads to serious neurological symptoms. We treat a 52-year-old man with sDAVF in the thoracic segment exhibiting uncoordinated gait. METHOD: Thoracic MRI of the lesion indicated myelomalacia and dilated blood vessels, while DSA revealed the right T6 radicular artery as the feeding arteriole. A full endoscopic obliteration of the lesion was performed under angiography guidance in a hybrid operation room...

BACKGROUND: The endoscopic transorbital approach provides a direct access to the medial temporal lobe (MTL). However, when excising a highly vascular tumour, a wider access route that enables the concurrent use of standard neurosurgical instruments with both hands is preferable. METHOD: We described the concept and technique of the lateral orbital wall approach (LOWA), which comprises orbitotomy and mini-craniotomy to treat MTL lesions using an exoscope and endoscope...

OBJECTIVES: Research highlights the benefits of critical action on individual and community well-being; however, more needs to be understood about the ways ethnic-racial socialization (ERS) influences emerging adults' participation in antiracism actions. METHOD: The present study examined patterns of parental ERS messages received by a sample of 668 racially and ethnically minoritized emerging adult college students ( M age = 18.76, SD = 1.23; female = 81.8%), and their associations with the emerging adults' demographic characteristics and three forms of antiracism actions...

BACKGROUND: To improve hearing function after resection of large vestibular schwannomas, we describe a strategy of vestibular-nerve-fiber preservation. Anatomical considerations and stepwise dissection are described. METHOD: Steps include locating the vestibular nerve at the brainstem and identifying a dissection plane between nerve fibers and tumor capsule. Using this plane to mobilize and resect tumor reduced manipulation and maintained vascularity of underlying cochlear and facial nerves...

Hodgkin lymphoma is characterized by a high cure rate in the modern era of medicine regardless of stage, but patients suffer from a high risk of comorbidity associated with the administered therapy. The main aim of this review article is to assess and analyze the various comorbidities associated with Hodgkin lymphoma and address the survivorship of patients, including fertility, secondary cancers due to cardiovascular toxicity, and quality of life. Furthermore, this review explores the optimal strategy for detecting relapse...

BACKGROUND: To treat extradural solid-cystic lesions of the ventral skull base, a pedicled nasoseptal flap (NSF) maintains patency of the marsupialized cavity and prevents restenosis and cyst recurrence. METHODS: The authors provide a step-by-step description of the surgical technique valid in different lesions of the skull base, all treated via the endoscopic endonasal approach (EEA). The application is demonstrated by an operative video. CONCLUSION: In selected lesions, endoscopic marsupialization using an NSF ensures drainage and ventilation of the surgical cavity...

Left subclavian artery revascularization at the time of thoracic endovascular aortic repair has been the subject of discussion for over a decade. Contemporary viewpoints suggest that revascularization should be performed where possible to decrease the risk of perioperative stroke, spinal cord ischemia, and, to a lesser degree, loss of upper extremity function. In this article, we present traditional methods as well as descriptions of newer options and technology for preservation of left subclavian artery flow during thoracic endovascular aortic repair...

Arterial and venous thromboses are classically considered distinct disease states, with arterial thrombosis mediated predominantly by platelets and, therefore, treated with antiplatelet therapy, and venous thrombosis mediated by the plasmatic coagulation system and, therefore, treated with anticoagulation. However, co-occurrence of arterial and venous events is common, and there is increasing evidence of shared risk factors and pathophysiologic overlap. This presents a management challenge: Does the patient with venous and arterial thrombosis require anticoagulation, antiplatelet therapy, or both? Herein, we present a structured approach to the evaluation and management of patients with venous thrombosis who are also at risk for or have a history of an arterial thromboembolic event...