How do patients' clinical phenotype and the physiological mechanisms of the operations impact the choice of bariatric procedure?

Bariatric surgery is currently the most effective option for the treatment of morbid obesity and its associated comorbidities. Recent clinical and experimental findings have challenged the role of mechanical restriction and caloric malabsorption as the main mechanisms for weight loss and health benefits. Instead, other mechanisms including increased levels of satiety gut hormones, altered gut microbiota, changes in bile acid metabolism, and/or energy expenditure have been proposed as explanations for benefits of bariatric surgery. Beside the standard proximal Roux-en-Y gastric bypass and the biliopancreatic diversion with or without duodenal switch, where parts of the small intestine are excluded from contact with nutrients, resectional techniques like the sleeve gastrectomy (SG) have recently been added to the armory of bariatric surgeons. The variation of weight loss and glycemic control is vast between but also within different bariatric operations. We surveyed members of the Swiss Society for the Study of Morbid Obesity and Metabolic Disorders to assess the extent to which the phenotype of patients influences the choice of bariatric procedure. Swiss bariatric surgeons preferred Roux-en-Y gastric bypass and SG for patients with type 2 diabetes mellitus and patients with a body mass index >50 kg/m(2), which is consistent with the literature. An SG was preferred in patients with a high anesthetic risk or previous laparotomy. The surgeons' own experience was a major determinant as there is little evidence in the literature for this approach. Although trends will come and go, evidence-based medicine requires a rigorous examination of the proof to inform clinical practice

Avoiding Predatory Publishing: The Role of Librarians in Faculty Education

Predatory publishing has become an increasing problem in recent years. Due to a lack of awareness about predatory publishers, faculty authors are at risk of harming their reputations by publishing their research in questionable journals. Librarians can play a vital role in educating faculty authors about this important topic. This session will review a variety of outreach and educational efforts that have been successful in educating faculty about the risks of predatory publishing at Himmelfarb Health Sciences Library including the creation of a comprehensive LibGuide, faculty consultation services, workshops, and social media posts. Future opportunities for outreach will also be explored including the development of a scholarly publishing literacy curriculum, creating partnerships with key departments, and targeted departmental education efforts

Uvod u posebno izdanje o filozofiji medicine

This article is an introduction to the special issue on philosophy of medicine. Philosophy of medicine is a field that has flourished in the last couple of decades and has become increasingly institutionalized. The introduction begins with a brief overview of some of the most central recent developments in the field. It then describes the six articles that comprise this issue.Ovaj je članak uvod u posebno izdanje o filozofiji medicine. Filozofija medicine je područje koje je procvjetalo u posljednjih nekoliko desetljeća i postaje sve više institucionalizirano. Uvod počinje kratkim pregledom nekih od najvažnijih najnovijih zbivanja na tom području. Zatim opisuje šest članaka koji sačinjavaju ovo posebno izdanje

Multi-professional healthcare teams, medical dominance, and institutional epistemic injustice

Multi-professional teams have become increasingly common in healthcare. Collaboration within such teams aims to enable knowledge amalgamation across specializations and to thereby improve standards of care for patients with complex health issues. However, multi-professional teamwork comes with certain challenges, as it requires successful communication across disciplinary and professional frameworks. In addition, work in multi-professional teams is often characterized by medical dominance, i.e., the perspective of physicians is prioritized over those of nurses, social workers, or other professionals. We argue that medical dominance in multi-professional teams can lead to institutional epistemic injustice, which affects both providers and patients negatively. Firstly, it codifies and promotes a systematic and unfair credibility deflation of the perspectives of professionals other than physicians. Secondly, it indirectly promotes epistemic injustice towards patients via leading to institutional opacity; i.e., via creating an intransparent system of credibility norms that is difficult to navigate. To overcome these problems, multi-professional teamwork requires institutional settings that promote epistemic equity of team members.</p

Speciation Patterns in Chewing Lice from Catharus Thrushes

Cospeciation is an interwoven process that impacts many organisms. It is important to study because no organism lives in a vacuum by itself. All organisms interact with other organisms on a daily basis. Some interactions are fleeting, whereas others may become more and more important as time progresses. This study attempts to discover if the interactions between parasitic chewing lice and their avian hosts are important enough to cause cospeciation. The first chapter of this work includes a literature review covering broad aspects that affect speciation. As this is a rather broad subject, I focused on antagonistic relationships and what I feel are the major factors that impact them: transmission and virulence. I focused especially on the specific interactions of chewing lice and their avian hosts, as they present an interesting system for a cospeciation study. After the basics of cospeciation and the factors the influence it have been laid out, in chapter 1, I use phylogenetic analyses of two genera of chewing lice, Brueelia and Myrsidea from Catharus thrushes to experimentally test whether they have cospeciated. I chose Catharus thrushes because they are common captures at the Shaw Woods Avian Monitoring Project (SWAMP) and I knew that they were often heavily infested with lice. Also there was a published phylogeny of the Catharus thrushes for me to compare to my parasite phylogeny

Living the High Life: Sceloporus malachiticus from High Elevations Perform Better at Extreme Temperatures

It is well known that activity, including sprint speed, is highly temperature dependent in ectothermic organisms. Because temperature changes across elevations, the wide elevational range of the lizard Sceloporus malachiticus in Costa Rica is an enigma. We tested thermal sensitivity of sprint speed in S. malachiticus from high (3500m) and low (2200m) elevation populations near Savegre Lodge in San Gerardo de Dota, Costa Rica. To test the hypothesis that lizards from low elevations have narrower thermal envelopes than lizards at high elevations, we conducted temperature controlled sprint trials on noosed lizards from both elevations. Lizards from both populations performed comparably at ambient temperature; however, high elevation lizards were faster at both extremes suggesting phenotypic differences between populations which may be explained by genetic variation or phenotypic plasticity. Such studies are essential to understanding the fundamental processes underlying speciation and adaptation