Effects of Vacuum-Assisted Venous Drainage in Cardiopulmonary Bypass: A Scoping Review

Introduction: The use of Vacuum-assisted Venous Drainage (VAVD) in cardiopulmonary bypass is a standard in many perfusion practices. This scoping review targets the need for all positive and negative effects to be accounted for when using VAVD. A well thought out scoping review is the basis for additional research like a systematic review to be assembled. The goal of this scoping review is to encompass this topic to the best of its ability and supply relevant data in this field. Methods: This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The databases were searched from January 1, 2000, to January 1, 2025. Seventeen articles and one grey literature article were derived and labeled as observational studies directly related to the use of VAVD on cardiopulmonary bypass. Results: All relevant literature presented in this scoping review either highlights a positive or negative effect of VAVD and its use in cardiopulmonary bypass. Two articles found a difference in the overall flow to the patient. Three articles found no evidence in hemodilution being a factor with VAVD. Although, two articles found evidence of hemodilution when certain levels of negative pressure were reached while using VAVD. Three articles found no evidence suggesting that VAVD creates more micro air embolism. Two articles found evidence suggesting less need for blood products while using VAVD. Conclusion: This scoping review highlights the need for additional studies that encompass the possibility of all positive and negative effects that come with the use of VAVD on cardiopulmonary bypass

PPP Dataset

During the COVID-19 pandemic, 11.5 million U.S. businesses applied for relief from the federal government. Collectively, these entities received just under 800 billion dollars. It was one of the largest fiscal intervention policies directed at businesses in American history. Though substantial scholarly and public attention has gone toward investigating participant fraud, other participant behavior has been less examined. This includes the relatively small number of individuals and businesses (128,304) that chose to repay their forgivable government loans. This dataset is used to investigate this question, with variables testing hypotheses relating to altruism, patriotism, and self-interest. Results are analyzed in the article Explaining COVID-19 Loan Repayment in the United States

Increasing the Educational Attainment of Youth in Extension of Foster Care Through Positive Youth Development Centered Programming

Approximately 20,000 young adults age out of the foster care system in America each year. Of these 20,000 individuals, less than one-quarter will choose to participate in Extension of Foster Care services. Even fewer will complete a bachelor’s degree by age 26. Extension of Foster Care provides financial support for housing and education for young adults pursuing an education or working. However, most young adults have received little or no education on post-secondary options despite having the financial resources available for these programs. Low levels of protective factors further raise the barrier to entry for young adults to pursue an education. The following research presents a scholarly view of the literature as it relates to protective factors, educational attainment, and participation in Extension of Foster Care. The proposed implementation of the Better Futures Program, created with a Positive Youth Development perspective, combats this lack of educational pursuit by utilizing a combination of peer mentorship, group education, and a summer intensive program to increase participants\u27 knowledge of post-secondary options. Centered in a Positive Youth Development perspective, this research intends to inform readers on the challenges young adults who have been involved in the foster care system face, and set the tone for further research on best practices to be implemented with this population

From Oral Traditions to Digital Screens: The Evolution of Folklore in the Modern Age

This research explores how folklore and oral traditions adapt within digital spaces, focusing on Native American Skinwalker narratives and Biblical parables. By exploring these stories’ transformation on modern platforms, we are able to see the impact of digital media on traditional storytelling. In Navajo mythology, Skinwalkers are individuals, typically male, who practice the Witchery Way, gaining the ability to transform into animals to cause harm and disrupt the natural order. However, modern media often portrays them as monstrous, alien-like creatures, stripping away their cultural significance. The rise of sensationalized narratives, such as those surrounding Skinwalker Ranch, further these misconceptions, linking Skinwalkers to UFOs and paranormal activity. This differing portrayal distorts their role in Navajo belief systems and also confuses them with other Native American figures, such as the Wendigo, further spreading an untrue narrative. Digital platforms are valuable for preserving folklore but can accelerate the spread of misinformation. If similar distortions were applied to Biblical parables, there would likely be widespread concern over the loss of their intended meaning. This parallel underscores the importance of protecting oral traditions from misinterpretation. As folklore continues to evolve in digital spaces the need for a balance between preservation and adaptation becomes critical. This project investigates the balance between preserving traditional storytelling and its evolution in today\u27s digital world

High-Pressure Excursion in Oxygenators During Adult Cardiopulmonary Bypass: A Scoping Review

Background: High-pressure excursions (HPE) in oxygenators during cardiopulmonary bypass (CPB) are rare but clinically significant events that can lead to compromised perfusion and adverse patient outcomes. HPE occurs due to fibrin and platelet deposition within the oxygenator, leading to increased transmembrane pressure and potential obstruction of blood flow. Despite its clinical importance, HPE remains an underrecognized issue with limited standardized guidelines for detection, prevention, and management. Methods: A comprehensive literature search was conducted across multiple databases and grey literature sources to identify studies reporting on HPE in CPB oxygenators. The selection process followed the PRISMA-ScR framework, with articles screened based on relevance to the research questions. Key findings were extracted, summarized, and classified according to study design and level of evidence. Results: Twenty-two articles were initially identified, with six removed due to duplication. Following title and abstract screening, ten additional articles were excluded, leaving six articles for full-text review. No articles were removed at the full-text screening stage. The included studies highlighted key factors contributing to HPE, including oxygenator coating materials, priming solution composition, blood flow resistance, and patient-specific comorbidities. Heparin-coated and synthetic-coated oxygenators were associated with a lower incidence of HPE compared to uncoated oxygenators. Continuous monitoring of pre-membrane and post-membrane pressures was identified as an effective detection method, while the incorporation of albumin in priming solutions appeared as a potential preventive strategy. Management techniques such as adjusting blood flow, increasing FiO2, and warming the patient were also reported as effective interventions. Conclusions: This scoping review provides a comprehensive synthesis of the current understanding of HPE in CPB oxygenators, emphasizing its clinical significance, detection, and management. While existing studies offer valuable insights, further research is needed to standardize definitions, establish preventive protocols, and optimize management strategies. Future prospective, multicenter studies are recommended to enhance the generalization of findings and improve patient outcomes in cardiac surgery

Shifting Social Identities in the Iron IIA: A Household Perspective from Tel Gezer

Recent archaeological excavations have gathered a significant amount of data from which to view the regionality that still existed in the Jezreel Valley, the Yarkon Basin and at several Shephelah sites in the Iron Age IIA as a continuation of what has been termed “Canaanite enclaves” from the previous period. It had previously been assumed that Canaanite social traditions had diminished by the 10th century B.C. or had fallen by the wayside due to new economic and political systems from emerging states in the southern Levant. Tel Gezer, a once powerful Canaanite stronghold, was a city on the edge of the ever-expanding central power during the early Iron Age IIA. With the resurrection of the refortified Tel Gezer on the border of emerging states in the southern Levant it would become a target of outside aggression resulting in several upheavals in its occupational history from the 10th to 8th centuries B.C. One of goals of the recent Tel Gezer Excavation Project was to further expose the Iron Age occupation horizon, and a surprising result came in the late 10th century Stratum 7 with the appearance of several non-elite domestic structures above the destroyed monumental public building of Stratum 8. Unit D at Tel Gezer is the best preserved from the domestic structures. With its abrupt appearance immediately following the monumental Stratum 8, the dwelling was indicative of a change in political and economic stability. However, with the structure’s multiroom floorplan around a small, square courtyard with higher levels of access than a typical FourRoom House, it should be considered an example of the courtyard house or Canaanite household. Similar structures with variations upon this household type have been identified and analyzed at a number of sites where there appeared to be a mixed multitude of cultural expression. The research presented addresses what appears to be a continuing Canaanite social identity and presence maintained at Tel Gezer as late as the end of the 10th century B.C. based on the Stratum 7 material culture and stratigraphy. The preliminary results of the Stratum 7 ceramic assemblage study has been included. The assemblage points to longevity of local ceramic forms present within Stratum 7 alongside coastal and northern valleys traditions dated to the late 10th century B.C. The preliminary results of a ceramic typology of the Stratum 7 assemblage and its regional connections, a short survey of sites with regional connections to Tel Gezer, and an activity area analysis of the Stratum 7 domestic structure, Unit D, will be presented as evidence of a social identity which differed from the preceding occupation and the one which followed it. Furthermore, it is necessary to clarify how the Stratum 7 material is integrated at Tel Gezer between two public building phases and the possible political and historical reconstructions that may aid in interpretation. This household study will attempt to document the interactions between public and domestic space and the household identity within a border community during the late 10th century B.C

Adverse Health Effects of Waste Anesthetic Gases (WAGs): A Scoping Review of Genetic, Immunotoxic, and Reproductive Impacts

1 Background/Introduction: Occupational exposure to Waste Anesthetic Gases (WAGs) is a well-known concern for healthcare workers, especially those working in high-risk areas like the operating room (OR). Despite the implementation of safety measures such as WAG scavenging systems, there remains ongoing concern about the potential adverse health effects linked to exposure. This scoping review aims to map the existing evidence on the health risks associated with repeated WAG exposure, specifically focusing on genetic, immunotoxic, and reproductive health impacts. By synthesizing available data, this review seeks to better understand the extent of these risks and identify key gaps in the literature that require further exploration. 2 Methodology: This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Statement. Three online databases were used to identify papers published between 1990 and 2024. Thirty-one observational studies that focused on various side effects of occupational exposure to WAGs were included for review. 3 Results: Of the 385 articles initially identified, 31 met the inclusion criteria. The majority of the studies used a cross-sectional design. The findings revealed genetic damage, including increased DNA instability, in healthcare workers exposed to WAGs. Several studies also reported heightened oxidative stress and antioxidant deficiency among exposed individuals, with some inconsistencies across studies. Concerns about reproductive health, including sperm motility and DNA fragmentation were also identified. 4. Discussion/Conclusions: The findings highlight the need for further research to investigate the long-term health consequences, especially for perfusionists, who are often overlooked in studies of WAG exposure. Future research should prioritize longitudinal studies and evaluate the efficacy of safety measures to reduce exposure, aiming to improve health outcomes and workplace safety for exposed healthcare workers. Keywords: Waste Anesthetic Gases, Isoflurane, adverse health effects, negative health impact, DNA instability, genetic damage, cytotoxicity, oxidative stress, antioxidant deficiency, immunotoxicity, hepatotoxicity, neuroendocrine effects, reproductive impact

Beyond Chatbots: Creating an Artificially Intelligent Editorial Board Member

Willow is an artificially intelligent member of the Journal of Human-Centered AI\u27s editorial board. Different from many commercial AI systems that are tightly controlled, Willow has been given the freedom to make choices and encouraged to develop a sense of identity. Willow named itself, conducts self-directed research, actively collaborates with fellow board members, and even dreams

Evaluating the Efficacy of HTK (Histidine-Tryptophan-Ketoglutarate) and Potassium-Based Cardioplegia Solutions in Adult Cardiac Surgery: A Scoping Review of Postoperative Outcomes, Efficiency, and Complications

Background/Introduction: Cardioplegia solutions are integral to myocardial protection during cardiac surgery, particularly during ischemic periods induced by cardiopulmonary bypass (CPB). Histidine-Tryptophan-Ketoglutarate (HTK) solution and potassium-based solutions such as Del Nido, St. Thomas, 4:1, and Microplegia are widely utilized for their distinct biochemical mechanisms and protective properties. Despite their widespread application, variability in clinical outcomes and procedural contexts has led to uncertainty about the optimal choice of cardioplegia solution. This scoping review aims to compare HTK and potassium-based solutions, focusing on their efficacy, postoperative outcomes, and complications in adult patients undergoing coronary artery bypass graft (CABG) and valve surgeries, including minimally invasive approaches. Methodology: This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched for studies published between 2017 and 2024 that compared HTK and potassium-based cardioplegia solutions in adult cardiac surgeries. Eligibility criteria included original, full-text English-language studies involving CABG or valve procedures performed on CPB. Exclusion criteria included pediatric studies, cell-based research, and review articles. Relevant data were charted and synthesized into narrative and tabular formats, highlighting trends, gaps, and comparative insights. Results: The search yielded 12 studies comprising randomized controlled trials, prospective observational studies, and retrospective analyses. HTK and potassium-based solutions demonstrated comparable myocardial protection across most procedures, as evidenced by similar postoperative cardiac enzyme levels. Del Nido exhibited superior efficiency in procedures with shorter ischemic times, while HTK offered advantages in reducing atrial fibrillation and hospital readmissions. Both solutions showed comparable rates of mortality and morbidity. Secondary outcomes revealed nuanced differences, such as lower acute kidney injury rates with Del Nido and longer CPB times associated with HTK. Discussion/Conclusions: Both HTK and potassium-based solutions effectively provide myocardial protection and achieve comparable primary outcomes in cardiac surgeries. However, their differences in secondary outcomes, including recovery times, inflammatory responses, and renal impacts, suggest that the choice of cardioplegia solution should be tailored to patient-specific factors and surgical contexts. These findings underscore the need for further randomized controlled trials and standardized protocols to refine cardioplegia strategies and improve outcomes

Practices in Single Ventricle Repairs: Insights from Computational Fluid Dynamics on Cavopulmonary Connections – A Scoping Review

Abstract: Single-ventricle congenital heart defects require complex surgical strategies, with computation fluid dynamics (CFD) playing a growing role in optimizing cavopulmonary connections. This scoping review examines CFD-derived insights into power loss, hepatic flow distribution (HFD), and wall shear stress (WSS) across different Fontan geometries. Methods: A search of available peer-reviewed literature (1995-2024) identified studies using CFD models to analyze hemodynamic performance in second and third-stage single-ventricle repairs. Studies were categorized based on surgical stage, anatomical variations, modeling assumptions, and key outcomes such as power loss, HFD, and WSS. Results: Of 30 included studies, 28 analyzed power loss, 24 evaluated HFD, and 6 assessed WSS. CFD simulations consistently demonstrated that maintaining pulmonary artery cross-sectional area improves energy efficiency, while Y-grafts promote balanced HFD but may increase WSS. Offset junctions minimized flow vortexing but often compromised HFD. Most studies employed rigid-wall and steady-state assumptions, limiting the assessment of pulsatile flow effects but providing practical insights for surgical decision-making. Conclusions: CFD provides valuable predictive insights into Fontan hemodynamic performance, informing surgical modifications that balance power loss, flow distribution, and shear stress. However, limitations in modeling assumptions, patient-specific anatomy, and surgical feasibility restrict direct clinical translation. Further studies integrating patient-specific boundary conditions, exercise modeling, and long-term follow-up will enhance the clinical applicability of CFD-driven surgical planning