Stilling Rose (elbowgrouse1)

Background This study aimed to report a European multi-institutional experience about thoracoscopic management of children with congenital lung malformations. Methods The records of 102 patients (49 girls and 53 boys) with median age at surgery of 1 year (range 6 months-1.5 years), who underwent thoracoscopic lobectomy in five European Pediatric Surgery units, were retrospectively collected. Indications for surgery included congenital pulmonary airway malformation (CPAM) (n = 47), intra- and extralobar pulmonary sequestration (n = 34), hybrid lesion (CPAM/intralobar sequestration) (n = 2), severe bronchiectasis (n = 9), congenital lobar emphysema (n = 8), and others (n = 2). The condition was asymptomatic in 77/102 (75.5%), whereas symptoms such as recurrent pneumonia and/or respiratory distress were present in 25/102 (24.5%). Results Surgical procedures included 18 upper, 20 middle, and 64 lower lobe resections. No conversions to open were reported. A 3 mm sealing device and 5 mm stapler were adopted in the ally easier, despite the small patients' size. Surgeon's experience and use of miniaturized instruments and sealing devices remain key factors for successful outcome.The current study evaluated the influence of resting muscle sympathetic nerve activity (MSNA) burst size and firing pattern on time-to-peak sympathetic transduction in 36 young healthy men and women. Participants underwent a 5-10 min resting baseline with beat-to-beat measures of heart rate, mean arterial pressure (MAP), and MSNA (microneurography). Cardiac output and total vascular conductance were calculated using the Modelflow algorithm. Sympathetic transduction was quantified using the burst-triggered signal averaging technique to examine the changes in MAP, cardiac output, and total vascular conductance for 15 cardiac cycles after each MSNA burst or non-burst. A stepwise increase in the peak MAP (i.e., sympathetic transduction) was observed throughout all quartiles of normalized MSNA burst area (quartile 1 (Q1) 1.7 ± 1.3 mm Hg; Q2 2.1 ± 1.3 mm Hg; Q3 2.6 ± 1.4 mm Hg; Q4 3.5 ± 1.4 mm Hg; P less then 0.01). The largest quartile of normalized MSNA burst area demonstrated faster time-to-peak MAP responses (5.7 ± 2.5 s) than both Q1 (10.1 ± 3.9 s, P less then 0.01) and Q2 (9.3 ± 4.1 s, P less then 0.01), as well as, faster time-to-peak cardiac output and time-to-nadir total vascular conductance compared with Q1 and Q2 (All P less then 0.05). Larger clusters of sympathetic bursts (i.e., triplets and ≥ quadruplets) did not have increased time-to-peak transduction compared with singlets and doublet bursts across all MSNA quartiles. These results highlight intraindividual variability in the time-course of sympathetic transduction and reveal an intrinsic property of larger sympathetic bursts to increase time-to-peak sympathetic transduction in humans. Novelty Muscle sympathetic burst size can modulate time-to-peak sympathetic transduction in young healthy men and women. These observations appear independent of the pattern of sympathetic firing.Background Many women see an obstetrician/gynecologist (OB/GYN) annually and receive their primary care from an OB/GYN. Understanding OB/GYNs' human papillomavirus (HPV) vaccination practices, including knowledge of and barriers to vaccination, is essential to design effective interventions to increase vaccination. This study evaluated OB/GYN knowledge, attitudes, and beliefs regarding vaccinating both younger (18-26 years) and mid-adult (27-45 years) women. Materials and Methods Data were collected from OB/GYN providers in October 2019 through a nationwide web-based survey. Items included the following HPV-related vaccination practices, recommendation strength, knowledge (seven items), benefits (four items), and barriers (eight items). Results The sample (n = 224) was majority were White (69%), men (56%), and practice in suburban clinics (55%). Most (84%) reported they usually or always recommend HPV vaccine to eligible pa