Bold Type Research Articles

Enhanced Recovery After Surgery (ERAS) cardiac turnkey order set for perioperative pain management in cardiac surgery: Proceedings from the American Association for Thoracic Surgery (AATS) ERAS Conclave 2023

ObjectiveOptimal perioperative pain management is an essential component of perioperative care for the cardiac surgical patient. This turnkey order set is part of a series created by the Enhanced Recovery After Surgery Cardiac Society, first presented at the Annual Meeting of The American Association for Thoracic Surgery in 2023. Several guidelines and expert consensus documents have been published to provide guidance on pain management and opioid reduction in cardiac surgery. Our objective is to consolidate that guidance into an evidence-based order set that will assist in the implementation of a comprehensive multimodal approach to pain management. MethodsSubject matter experts were consulted to translate existing guidelines and peer-reviewed literature into a sample turnkey order set for pain management. Orders derived from consistent Class I, IIA, or equivalent recommendations across referenced guidelines and consensus manuscripts appear in the order set in bold type. Selected orders that were inconsistently Class I or IIA, Class IIB, or supported by published evidence, were also included in italicized type. ResultsOpioid-based analgesia is associated with delayed recovery and opioid-related adverse events. Several multimodal medications have been shown to reduce reliance upon opioids. These include the scheduled use of acetaminophen, gabapentinoids, and nonsteroidal anti-inflammatory drugs. In addition, intravenous analgesics such as dexmedetomidine, ketamine, magnesium, and lidocaine have been shown to both complement the maintenance of anesthesia as well as optimize pain control postoperatively. Long-acting opioids remain a key component of pain management when provided to reduce the overall use of short-acting synthetic opioids or in direct response to break though pain after exhausting other alternatives. When applied in a bundled fashion, several studies have demonstrated a reduction in overall opioid administration and improved rates of postoperative recovery. ConclusionsThere has been increased awareness regarding the potential short- and long-term adverse effects of both inadequate analgesia and excessive opioid administration after cardiac surgery. This turnkey order set aims to facilitate implementation of a comprehensive approach toward provision of multimodal, opioid-sparing medications to optimize pain management in cardiac surgery.

Some Remarks About the Translation of Yun Lintang Yinshi Zhidu Ji Published in PPC 60

Readers who enjoyed the translation (in PPC 60) by Teresa Wang and EN Anderson of the culinary work by the 14th century Chinese artist Ni Tsan, and who are glad to have this work on their shelves for subsequent reference, will welcome the additional comments, and proposed corrections, which have been provided by Françoise Sabban, a French professor who has specialized in Chinese food and cuisine. In what follows, words printed in bold type represent the proposed corrections.

Preoperative medication management turnkey order set for nonemergent adult cardiac surgery

ObjectiveThe management of preoperative medications is an essential component of perioperative care for the cardiac surgical patient. This turnkey order set is part of a series created by the Enhanced Recovery After Surgery Cardiac Society, first presented at the Annual Meeting of The American Association for Thoracic Surgery in 2023. Numerous guidelines and expert consensus documents have been published to provide guidance in preoperative medication management. Our objective is to integrate these documents into an evidence-based order set that will facilitate standardized implementation of best practices for preoperative medication management for nonemergent adult cardiac surgery. MethodsSubject matter experts were consulted to translate existing guidelines and peer reviewed literature into a sample turnkey order set for the preoperative management of patients’ medications. Orders derived from consistent Class I, IIA, or equivalent recommendations across referenced guidelines and consensus manuscripts appear in the order set in bold type. Selected orders that were inconsistently Class I or IIA, Class IIB, or supported by published evidence, were also included in italicized type. ResultsHolding antiplatelet and anticoagulant medications before nonemergent cardiac surgical procedures may reduce the risk of bleeding. Sodium-glucose co-transporter-2 inhibitors and glucagon-like peptide-1 agonists should also be discontinued to prevent acidosis and aspiration, respectively. Specific guidance for frequently used medications are complied within the manuscript, less frequently used medications are listed seperately. ConclusionsDespite strong recommendations from major guidelines and consensus manuscripts, variation exists in preoperative medication orders, with limited availability of succinct implementation tools. This turnkey order set may facilitate standardized comprehensive preoperative medication management before nonemergent cardiac surgery.

Enhanced Recovery After Surgery Cardiac Society turnkey order set for surgical-site infection prevention: Proceedings from the American Association for Thoracic Surgery ERAS Conclave 2023

ObjectivesSurgical-site infections (SSIs) after cardiac surgery increase morbidity and mortality, consume health care resources, impair recovery, and diminish patients’ quality of life. Numerous guidelines and expert consensus documents have been published to address the prevention and management of SSIs. Our objective is to integrate these documents into an order set that will facilitate the adoption and implementation of evidence-based best practices for preventing and managing SSIs after cardiac surgery. MethodsSubject matter experts were consulted to translate existing guidelines and literature into a sample turnkey order set for SSI reduction. Orders derived from consistent class I, IIA, or equivalent recommendations across referenced guidelines and consensus manuscripts appear in the turnkey order set in bold type. Selected orders that were inconsistent class I or IIA, class IIB or otherwise supported by published evidence, were also included in italicized type. ResultsPreventative care begins with the preoperative identification of both modifiable and nonmodifiable SSI risks by health care providers. Assessment tools can be used to assist in identifying patients at a high risk of SSI. Preoperative recommendations include screening for and treating Staphylococcus aureus nasal carriage. Intraoperatively, tailored prophylactic intravenous antibiotics and maintaining blood glucose levels below 180 mg/dL are essential elements. Postoperative care includes maintaining normothermia, glucose control and patient engagement. ConclusionsDespite the well-documented advantages of a multidisciplinary care pathway for SSI in cardiac surgery, there are inconsistencies in its adoption and implementation. This article provides an order set that incorporates recommendations from existing guidelines to prevent SSI in the cardiac surgical population.

How to Sell a Poison: The Rise, Fall, and Toxic Return of DDT

How to Sell a Poison: The Rise, Fall, and Toxic Return of DDT

How to Sell a Poison: The Rise, Fall, and Toxic Return of DDT

How to Sell a Poison: The Rise, Fall, and Toxic Return of DDT

Enhanced Recovery After Surgery Cardiac Society turnkey order set for prevention and management of postoperative atrial fibrillation after cardiac surgery: Proceedings from the American Association for Thoracic Surgery ERAS Conclave 2023

BackgroundPostoperative atrial fibrillation (POAF) is a prevalent complication following cardiac surgery that is associated with increased adverse events. Several guidelines and expert consensus documents have been published addressing the prevention and management of POAF. We aimed to develop an order set to facilitate widespread implementation and adoption of evidence-based practices for POAF following cardiac surgery. MethodsSubject matter experts were consulted to translate existing guidelines and literature into a sample turnkey order set (TKO) for POAF. Orders derived from consistent class I or IIA or equivalent recommendations across referenced guidelines and consensus manuscripts appear in the TKO in bold type. Selected orders that were inconsistently class I or IIA, class IIB, or supported by published evidence appear in italic type. ResultsPreoperatively, the recommendation is to screen patients for paroxysmal or chronic atrial fibrillation and initiate appropriate treatment based on individual risk stratification for the development of POAF. This may include the administration of beta-blockers or amiodarone, tailored to the patient's specific risk profile. Intraoperatively, surgical interventions such as posterior pericardiotomy should be considered in selected patients. Postoperatively, it is crucial to focus on electrolyte normalization, implementation strategies for rate or rhythm control, and anticoagulation management. These comprehensive measures aim to optimize patient outcomes and reduce the occurrence of POAF following cardiac surgery. ConclusionsDespite the well-established benefits of implementing a multidisciplinary care pathway for POAF in cardiac surgery, its adoption and implementation remain inconsistent. We have developed a readily applicable order set that incorporates recommendations from existing guidelines.

Exploring the prevalence of success stories in popular work-related television series: A content analysis

This content analytical study (N = four series, 59 characters, and 2411 scenes) investigates how success stories are portrayed in work-related television series (i.e., television series centered on the working environment) that are available in several countries, namely Suits, Grey's Anatomy, The Bold Type, and The Good Doctor. Based on the ideas of cultivation theory, this study explores how such television series define (professional) success and whether the accomplishments portrayed in them adhere to the malleability narrative (i.e., a narrative in which success is portrayed as achievable by everyone provided they work hard for it). By analyzing the main and secondary characters, this study explores which character traits are associated with (professional) success and examines the presence of references to personal accountability and perseverance.

Panicle Architecture in Enhancing Grain Yield in Rice (Oryza sativa L.)

The architecture of the rice panicle is a crucial focus in breeding for both high yield and quality. It stands as a significant agronomic trait that influences the number of grains per panicle, playing a direct role in contributing to the overall yield of rice grains. Unravelling the genetic basis of panicle architecture is crucial for improving the grain yield in rice. In this study, the panicle architecture traits were meticulously dissected into five distinct components viz., number of primary rachis, number of secondary rachis, grain number on primary rachis, grain number on secondary rachis and total grain number. These components were systematically phenotyped in F2 and F3 population derived from a cross between DRR Dhan 48 and Maudamani. ‘DRR Dhan 48’ is a biofortified elite fine grain medium slender grain type cultivar with high zinc (22 ppm in polished rice) and low glycemic index (51.1). It has resistance to bacterial blight with the incorporation of xa5, xa13 and Xa21 in the background of Improved Samba Mahsuri. ‘Maudamani’ is a high yielding cultivar with high grain number and short bold grain type. Analysis of variance, histograms and boxplots revealed highly significant variation for the studied traits. Grain number in F2 population ranged from 29 to 333 grain with a mean of 162.72 whereas in F3, its varied from 49 to 368 with a mean of 184.17. Correlation analysis revealed significant correlation among the studied traits. The continuous variation observed in the population for panicle traits indicates that genetic control is governed by multiple minor loci. The presence of superior transgressive segregants highlights a complementary gene action influencing panicle architecture traits. The present investigation on panicle architecture offers scope for improving rice varieties and creating new germplasm resources and provides valuable information for further unravelling the genetic basis determining rice panicle architecture.

Ryan, Hugh. (2022). The Women’s House of Detention: A Queer History of a Forgotten Prison. New York, NY: Bold Type Books

Ryan, Hugh. (2022). The Women’s House of Detention: A Queer History of a Forgotten Prison. New York, NY: Bold Type Books

ERAS Cardiac Society turnkey order set for patient blood management: Proceedings from the AATS ERAS Conclave 2023

ObjectivesThere are multiple published guidelines on comprehensive patient blood management (PBM), centered on the 3 pillars of PBM: managing preoperative anemia, minimizing blood loss, and tolerating intraoperative/postoperative anemia. We sought to create an order set to facilitate widespread implementation of evidence-based PBM for cardiac surgery patients. MethodsSubject matter experts were consulted to translate existing guidelines and literature into a sample turnkey order set (TKO) for PBM. Orders derived from consistent class I, class IIA, or equivalent recommendations across referenced guidelines and consensus manuscripts appear in the TKO in bold type. Selected orders that were inconsistently class I or IIA, class IIB, or supported by published evidence are presented in italic type. ResultsPreoperatively, there are strong recommendations to screen and treat preoperative anemia with iron replacement and erythropoietin and to discontinue dual antiplatelet therapy if the patient can safely wait for surgery. Intraoperative orders outline the routine use of an antifibrinolytic agent, cell saver, point of care viscoelastic testing, and use of a standard transfusion algorithm. The order set also reflects strong recommendations intraoperatively and postoperatively for agreed-upon hemoglobin thresholds to consider transfusion of packed red blood cells. A hemoglobin threshold should be adopted according to local team consensus and should trigger a discussion regarding transfusion. ConclusionsThe benefit of a multidisciplinary PBM care pathway in cardiac surgery has been well established, yet implementation remains variable. Using recommendations from existing guidelines, we have created a TKO to facilitate the implementation of PBM.

Neoliberal feminism and intergenerational relations at work: an analysis of media representations of feminist mentorship in popular culture

ABSTRACT Generational conflict is often understood as central to social change, and more so concerning the development of feminism, as expressed through the mapping of feminist history in opposing waves. The opposition between younger and older women is also a common trope in popular culture, often aimed at describing the conflict between different generations of women and their understanding of gender and gender relations. However, since the emergence of the #MeToo phenomenon in 2016, new representations of intergenerational female relationships have emerged, specifically in the workplace. In this context, conflict does not necessarily foreclose dialogue, but is part of a more rounded relationship that encompasses solidarity and growth, taking the shape of feminist mentorship. Through the analysis of three popular shows (The Good Fight, The Bold Type, Hacks), I investigate the emergence of the trope of feminist mentorship in popular culture and argue that, while these texts offer more positive representations of intergenerational feminist relations, they expand neoliberal feminism’s focus on workplace success for female empowerment by making work the preferred site of feminist activism.

Baldwin, Davarian (2021) In the Shadow of the Ivory Tower: How Universities Are Plundering Our Cities. Bold Type Books.

Baldwin, Davarian (2021) In the Shadow of the Ivory Tower: How Universities Are Plundering Our Cities. Bold Type Books.

LA TRADUCCIÓN DE LA NOVELA GRÁFICA: PERSPECTIVA SEMIOLÓGICA Y MULTIMODAL

LA TRADUCCIÓN DE LA NOVELA GRÁFICA: PERSPECTIVA SEMIOLÓGICA Y MULTIMODAL

Hedges as A Conversational Strategy in Women’s Gossip in The Bold Type Season 1

This study aims to explore the functions of hedges employed in women’s gossip by all female characters in The Bold Type Season 1. This study applied Coates' (1996) classifications of hedges functions combined with two other functions proposed by Rabab’ah and Rumman (2015) to investigate the hedges function. The researchers employed a descriptive-qualitative method and collected the data by highlighting the transcript of the series to identify the conversations categorized as women’s gossip. The data were then analyzed in several steps; identifying by giving codes, classifying, interpreting or discussing, and making a conclusion. The study revealed that all four hedges’ functions by Coates and two functions by Rabab’ah and Rumman are found in female characters’ utterances in their gossip. Based on the study’s result, using hedges as a conversational strategy in female characters’ utterances smoothens their conversation during gossip. It can facilitate them to convey precise ideas when they exchange information and prevent them from delivering exaggerated information during gossip. It also helps them maintain solidarity and friendship between the participants, which is the overall function of female gossip. To conclude, hedges or hedging can be an influential conversational strategy in women’s gossip.

Repackaged sob sisters and outsiders within: reading the female and minority journalists on The Bold Type and The Morning Show

ABSTRACT Female and minority journalists in fiction movies and series are underrepresented and often framed as emotional, unstable, inexperienced, and unprofessional. These representations reiterate and preserve existing inequalities in Western newsrooms in which female and minority journalists face many obstacles ranging from the glass ceiling to a gender pay gap. However, these representations also have the potential to subvert and challenge existing structures and imagine more inclusive newsrooms. Therefore, this study proposes a qualitative textual analysis of the representation of female journalists in the American fiction series’ The Morning Show (AppleTV+, 2019) and The Bold Type (Freeform, 2017). Using a feminist media studies and intersectional perspective, it unpacks how the gendered power dynamics in newsrooms are represented in the series’ narratives. We find that The Bold Type represents an idealistic version of an inclusive work environment aimed at creating equal opportunities among journalists while at the same time embedding this in broader patriarchal structures that restrict this representation. The Morning Show claims a more critical approach by representing a pessimistic and dysfunctional newsroom and including an explicit critique of the power relations that disadvantage female minority journalists.

Adaptive Capacity of two Varieties of Groundnut (Arachis hypogaea L.) in Crude Oil Polluted Soil

Arachis hypogaea L. (Groundnut) production in Niger Delta, Nigeria is limited as the crop has not been well adapted to this region. This research was carried out to determine the adaptive capability of groundnut in crude oil polluted soil. Seeds of two varieties (Java and Bold Type) were planted in soil polluted with 0.8% and 0% of crude oil. Growth parameters were measured every 10 days up to 50 days after planting. Nodules were isolated from the roots 50 days after planting and cultured in YEMA solid medium and further subcultured in PDA medium to obtain pure cultures. Result showed that they adapted to the crude oil polluted soil with Java variety having the optimum agronomic performance, root architecture and rhizobium population. Nodules formed from day 10 to day 50 after planting shows that the highest number of nodules formation occurred on day 50 for the Java variety in polluted soil (32 nodules) while the bold variety had the lowest (5 nodules). Four fungal organisms identified in the pure-cultures were penicillium chrysogenum , Aspergillus niger , Mucor circinelloides , Botrydiplodia theobromae . This research suggested that the ability of groundnut to grow in crude oil polluted soil could be due to their root architecture and ability to fix nitrogen in the soil. Further adaptation studies should be carried out covering other part of Niger Delta region. Keywords: Groundnut, Nodule, Adaptive Capacity DOI: 10.7176/JBAH/13-4-06 Publication date: March 31 st 2023

The Kidnapping Club: Wall Street, Slavery, and Resistance on the Eve of the Civil War by Jonathan Daniel Wells

Reviewed by: The Kidnapping Club: Wall Street, Slavery, and Resistance on the Eve of the Civil War by Jonathan Daniel Wells Frank Towers (bio) The Kidnapping Club: Wall Street, Slavery, and Resistance on the Eve of the Civil War. Jonathan Daniel Wells. New York: Bold Type Books, 2020. ISBN 978-1568587523. 368 pp., cloth, $30.00. In recent years, historians have produced a wave of studies on the kidnapping and reenslavement of African Americans before the Civil War. Richard Bell, Erica Dunbar, Caleb McDaniel, Adam Rothman, and Joshua Rothman among others have shed light on the cruelty, pervasiveness, and legal complexity of kidnapping. They have also told stories of heroic resistance against the depraved pursuit of profit through stealing Northern Blacks from their homes to sell them in Southern slave markets. Adding to this scholarship, Jonathan Wells’s gripping history of kidnapping in 1830s New York exposes the proslavery underbelly of America’s largest city. At its core, The Kidnapping Club is a story of the battle for freedom in the ante-bellum North, a section that despite its ban on slavery denied African Americans basic civil liberties. Led by “the indomitable” Black activist David Ruggles, Black New Yorkers waged a long struggle against kidnappers and their powerful allies in local government. Wells argues that white New York’s complicity in kidnapping went beyond a few corrupt cops and judges. Wall Street financiers facilitated kidnapping to appease Southern slave owners, whose cotton comprised one of the most valuable commodities traded through New York. Because of this obeisance to the South, “it sometimes seemed that the entire city, knowing that its richness and supremacy depended on Southern slavery, was more interested in reassuring slaveholders than in protecting the basic human rights of its Black residents” (5). The Kidnapping Club begins by backgrounding the growth of New York as a gathering place for African Americans as well as the center of American finance and commerce, which drew much of its capital from trading slave-produced cotton. Black New Yorkers lived under a system of “strict racial segregation” that affected “nearly every aspect” of their lives (27). To thrive in a city that tried to [End Page 106] suppress them, they built their own businesses and institutions such as schools, churches, orphanages, and newspapers such as Freedom’s Journal, which exposed racial injustices. Preying on this growing community was a ring of kidnappers whose key players included police marshal and notorious Democratic Party brawler Isaiah Rynders, who worked with Southern slave traders to identify suspected fugitives; police officers Tobias Boudinot and Daniel Nash, who arrested suspected freedom seekers from the South; and City Recorder Richard Riker, who routinely ruled in favor of slave catchers in cases of alleged fugitives. These officials abused their authority by condemning Black defendants to enslavement despite compelling evidence to the contrary brought by Ruggles and his allies. The kidnappers had close ties to Tammany Hall—the informal name for the city’s branch of the Democratic Party—which relied on patronage from Wall Street businessmen to fund its campaigns. Helping Southern slave traders not only earned these men cash bribes and bounties, it also “cemented the economic relationship between cotton growers and Manhattan brokers” (45). To combat these powerful foes, Ruggles worked with other abolitionists to organize the New York Committee of Vigilance in 1835. The committee spread word when slave catchers were in town, gave sanctuary for freedom seekers, provided legal defense for accused fugitives, and waged a public pressure campaign against the kidnappers. Leading these efforts, Ruggles routinely risked his personal safety to confront police and rescue victims. This outspoken leadership made Ruggles a target of the kidnappers who physically assaulted him and tried to frame him for a crime. Meanwhile, Ruggles’s combativeness made him enemies within the Committee of Vigilance. Losing his eyesight and exhausted by fighting friends as well as foes, Ruggles left New York in 1841. Around this time, the kidnapping club went into decline. An 1840 law requiring jury trials in fugitive cases took away corrupt judges’ power to convict. Two years later, Riker died and Boudinot declared bankruptcy. Instead of ending the story at this point, Wells moves to the...

Bold resistance: Developing tenets of femme analysis for an era of popular feminism

Feminist analyses of postfeminism too often abject femininity, rendering spectacular femininity as a masquerade that endears women to heterosexual men. Moving into the era of popular feminism, feminist analyses have yet to renegotiate this abjection of femininity, often eclipsing the potential for resistance in favor of highlighting the pernicious effects of capitalism. Analyzing vignettes from The Bold Type (2017–2021), this research draws on femme theory to map an analytical framework that reinterprets spectacular femininity, developing strategies for critical analyses that can recognize fem(me)inine resistance within a landscape that commodifies femininity and feminism.

AI-Based Auto-Segmentation for Loco-Regional Breast Cancer Radiotherapy: Training, Validation and Clinical Implementation

<h3>Purpose/Objective(s)</h3> To train and validate a comprehensive deep-learning (DL) segmentation model for loco-regional breast cancer with the aim of clinical implementation. <h3>Materials/Methods</h3> 200 left-sided breast cancer cases from two radiotherapy centers in Norway were included in the project. In all cases, 7 clinical target volumes (CTVs) were manually delineated based on the ESTRO guidelines, in addition to 11 organs at risk (OARs). 170 patient cases were used for training, which involved neural networks of 3D CNN U-net type. The remaining 30 cases were used for model validation, which included: 1) evaluation of geometric similarity between DL structures and manually delineated structures using 95-percentile Hausdorff distance (HD95) and Dice similarity coefficient (DSC), benchmarked against inter-observer variation (IOV), 2) qualitative scoring using a 4-step scale according to clinical usability, and 3) dosimetric analysis of conformal treatment plans which were based on uncorrected DL structures. A dedicated team of 3 experienced oncologists (EO) and 3 experienced radiation therapists contributed to the manual delineations for model training and validation, while 5 EOs delineated the same 5 patient cases for evaluation of IOV. To test for difference in model performance and IOV, Mann-Whitney U test was used, while paired sample T-test was used for the dosimetric analysis of OARs. <h3>Results</h3> Geometrically, the model performed better than IOV for all CTVs and most OARs, see Table 1 for main results. Qualitatively, no or only minor corrections were required for 14 % and 71 % of the CTVs and 72 % and 26 % of the OARs, respectively. Major corrections were required for 15 % of the CTVs and 2 % of the OARs, while no structure scored as "not usable". The most frequent corrections were adjustments in the cranial and caudal parts of the structures. Dosimetrically, the CTV coverage, based on D98 > 95 %, was fulfilled for 100 % and 89 % of the breast and lymph node structures, respectively. No differences in OAR dose parameters were considered clinically relevant. The model was implemented in a commercial treatment planning system, which generates the structures in 1.5 minutes. <h3>Conclusion</h3> Convincing results from the validation process led to the decision of clinical implementation. The model is now in clinical use, and will be monitored regarding applicability, standardization and efficiency. Table 1. Geometric performance of the DL model and corresponding IOV for all CTVs and two of the OARs (median values). Bold type indicates the best metric, and underscore indicate statistical significance (p<0.05).