Society Website Research Articles

Unlocking Global Potential: Education and Funding Opportunities for International Trainees in Hematology

Introduction: the practice of hematology is in continued transformation fueled by scientific advances. However, access to training and education is not equally distributed worldwide, especially for under-represented groups such as trainees living in low and middle-income countries (LMICs). Differences in education and funding in the field remain understudied. Our goal was to identify and review the different educational and funding opportunities offered by national and international hematology-focused academic societies. We aimed to provide an overview of the current state of continuing education in hematology and present gaps and areas of opportunity. Methods: We performed an online search to identify national and international hematological societies, including those targeted to a specific field. We extracted data regarding educational and funding opportunities in hematology by systematically evaluating each society's website from August 2022 until February 2023. We included all educational opportunities available that focus on hematology and are relevant for physicians and physicians in training. We abstracted the type of educational opportunity, if a membership to the society is required, cost, language, topic, target audience restrictions and their geographic region, and learning modality. We also included hematology-focused career enhancing grants or awards, such as travel stipends, research, or career development funding. Results: 25 hematology societies were included with 850 continuing medical education opportunities, consisting of 174 courses, 18 training programs, 10 self-assessments, 641 clinical cases, 4 books and 3 apps. We also included 55 grants and funding opportunities from 13 societies with a median of $45,000 USD (range, $330-600,000). More than half (61.8%) required a membership to apply, only 5 (9.1%) were available globally, and only 7 (12.7%) were designed for persons in LMICs. Most funding opportunities were targeted to postgraduate students (40%) while the smallest proportion were intended for undergraduate students (10.9%) (Figure 1). Most funding opportunities were for research and career development (47.3%), or for research and travel stipends (40%), 7 (12.7%) were for traveling. The median duration of funding was 1 year (range, 1 month - 4 years). Almost all courses (96%) and 61.1% of training programs were conducted online. Most courses (78.7%) were directed to all levels of preparation (undergraduates, postgraduates, and specialists), half of them (52.9%) required a membership and 43.1% were free for members. Educational opportunities spanned multiple topics (23.5%) or focused on classical or malignant hematology in a similar proportion (19.5 and 20.7%, respectively). Specialized education opportunities were more common for thrombosis (9.8%), pathology (6.9%), general professional skills (5.2%) transfusion medicine (2.3%), transplant (2.3%), and public health (1.7%). Of the 18 longitudinal training programs, 44.4% did not require a membership, and two thirds were free for members and non-members (66.7%). However, only 3 (16.7%) training programs were available globally, and the rest were exclusive for specific world regions: Europe and Latin America had 2 (11%) programs each, while Asia-Pacific, LMICs, and USA had 1 (5.6) each. Courses and programs findings are summarized in Table 1. Conclusion: Funding opportunities remain limited to trainees from LMICs. Most online courses require a membership which implies a cost, limiting education for international trainees. Efforts should be made to create more opportunities for underrepresented trainees.

The long-term risk of cardiovascular disease among women with a history of hypertensive disorders of pregnancy: a systematic review of clinical practice guidelines

BackgroundThe lifelong risks of cardiovascular disease following preeclampsia and gestational hypertension are well-established. However, it is unclear whether this evidence has been translated into clinical practice guidelines. Thus, this review aimed to assess the quality and content of Australian clinical practice guidelines regarding the risk of cardiovascular disease following gestational hypertension and preeclampsia.MethodsWe conducted a systematic search of MEDLINE (Ovid), EMBASE (Ovid), and CINAHL databases, as well as hospital, obstetric society, and medical college websites. Publications were included if: they were a clinical practice guideline; were published in the previous ten years; and included recommendations for the management of future cardiovascular disease risk following hypertensive disorders of pregnancy. Quality assessment was performed using Appraisal of Guidelines for Research and Evaluation Instrument Version Two (AGREE-II) and AGREE Recommendations Excellence Instrument (AGREE-REX).ResultsEighteen guidelines were identified, and of these, less than half (n = 8) included recommendations for managing future cardiovascular risk following hypertensive disorders of pregnancy. Across these eight, four main counselling recommendations were found regarding (1) risk of future cardiovascular disease; (2) risk factor screening; (3) lifestyle interventions; and (4) prenatal counselling for future pregnancies. The quality and content of these recommendations varied significantly, and the majority of guidelines (87.5%) were assessed as low to moderate quality.ConclusionsThere are limited Australian clinical practice guidelines providing appropriate advice regarding future risk of cardiovascular disease following hypertensive disorders of pregnancy. The quality and content of these guidelines varied significantly. These findings highlight the need for improved translation from evidence-based research to enhance clinical care and guidance.

Lipohypertrophy and Insulin: An Update From the Diabetes Technology Society.

Lipohypertrophy is a common skin complication associated with insulin-treated diabetes. The impact of lipohypertrophy as a contributing factor to suboptimal glycemic control, glucose variability, and hypoglycemia is often under-recognized by health care professionals. In a recent Webinar on April 26, 2023, Diabetes Technology Society asked international experts to provide updates on the latest knowledge related to lipohypertrophy for practicing clinicians and educators, researchers, and industries involved in insulin delivery. A recording of the Webinar is freely available on the Diabetes Technology Society Web site (https://www.diabetestechnology.org/).

(039) Improve Your Online Findability: Search Engine Optimization for Providers of Patients with Vulvovaginal Pain

Abstract Introduction Women with vulvovaginal pain struggle to find detailed, reliable information, accurate diagnoses, and knowledgeable providers. It often takes many years and visits to multiple providers to reach diagnosis. One of the many factors impeding their journey is the small amount of information written for patients and difficulty locating what is available. Objectives The goal of this project was the compare the search terms used by patients looking for information before diagnosis to the search terms required to locate the desired information. Additionally, we sought to use those results to craft tips and best practices for sexual medicine providers and societies to improve their findability. Lastly, a case study was performed on our own website to demonstrate effects on findability. Methods To characterize the search terms required to locate detailed, reliable information on vulvodynia, an analysis was conducted on five websites with relatively comprehensive information written for patients. Three of the websites are owned by societies and two by individual practices. The top one hundred keywords were identified for each website using SEMrush analysis of organic traffic of the root domain. To characterize the search terms patients with vulvovaginal pain used to look for information before diagnosis, polls were conducted of members of three large online support groups and received over 400 votes. Inductive coding was used to identify emergent themes in the search terms and keywords. Results Poll results showed that the search terms used by patients were centered on their experiences. More than 90% of search terms directly described physical symptoms (such as vulvar/vaginal pain or burning) or a task they have difficulty with (such as inserting a tampon or intercourse). Less than 10% of search terms used by patients were names of sexual dysfunctions or vulvovaginal pain conditions. In contrast, preliminary analysis of the search terms required to locate information written for patients by providers or societies consisted of less than 25% physical symptoms (with more than half of these keywords coming from a single website) and about 30% names of sexual dysfunctions or vulvovaginal pain conditions. Based on this large discrepancy between patient search terms and informational websites’ keywords, we offer suggestions to improve searchability of providers and societies websites, such as using patients’ search terms in headers and webpage titles, blogging, and including links in content. Conclusions Women with vulvovaginal pain conditions, e.g. vulvodynia, vestibulodynia, clitorodynia, and pelvic floor muscle dysfunction, struggle to find information about these medical conditions online, in part due to discrepancy between the search terms they are using and the keywords of the desired websites. Simple changes to provider and society websites can begin to bridge this gap and help women find information and knowledgeable providers faster. Disclosure No.

Common Practice in the Treatment of Superficial Vein Thrombosis Involving the Sapheno-Femoral Junction: Results from a National Survey of the Italian Society of Angiology and Vascular Medicine (SIAPAV).

Background and Objectives: Prophylactic doses of low-molecular-weight heparins or fondaparinux showed their efficacy and safety for treatment of all superficial vein thrombosis (SVT) of the lower limbs, yet not for those extended to the last 3 cm of the great saphenous vein, close to the sapheno-femoral junction, or considered as a deep-vein thrombosis. Some experts suggest that these patients should be managed with full anticoagulant doses but evidence to support this recommendation is lacking, suggesting the need for a properly designed trial. Materials and Methods: Before starting a new trial, the Italian Society of Angiology and Vascular Medicine (SIAPAV) decided to verify the common therapeutic approaches for patients with an SVT in Italian vascular centers based on a hypothetical significant variation in each daily clinical practice. A standardized questionnaire of 10 questions was administered to all SIAPAV affiliates by means of the official Society website. Results: From 1 December 2022 to 20 January 2023 a total of 191 members (31.8%) answered the questionnaire, showing a detailed and a substantial heterogeneity in the therapeutic approach to SVT patients among experienced vascular physicians and angiologists. Detailed results are reported in the relative section. Conclusions: The therapeutic approach of SVT extended to the iuxta-femoral segment of the great saphenous vein is still a matter of debate, and data to support therapeutic strategies are lacking. The wide heterogeneity in the management of SVT patients, including those with more extended thrombosis, confirmed that a randomized controlled clinical trial investigating the efficacy and the safety of a tailored therapeutic regimen in this particular subgroup of patients is strongly warranted.

0905 Factors Associated with Sleep Quality among Men with Multiple Sclerosis

Abstract Introduction Multiple sclerosis (MS), a neurodegenerative disease with typical onset in young to middle adulthood, results in disrupted sleep more commonly than the general population. There are known sex differences in MS onset and clinical course. MS, however, affects approximately three times more women than men, resulting in less attention to the male experience. Thus, there is a lack of information on disrupted sleep among men with MS. The purpose of this study was to examine the relationships between personal factors, behaviors, and sleep quality among men with MS. Methods Men with MS aged 20 to 90 years participated in an online anonymous survey recruited through the National MS Society website. Pearson’s correlations and linear regression were used to examine relationships between personal factors (age (years), type of MS, years since MS was diagnosed by a physician and race), sleep promoting behaviors (Sleep Behavior Self-Rating Scale), and sleep quality (Sleep Impact Short-Form total score). Results Four hundred ninety-six men with MS (mean age=53 years; SD=12.8; range 22-81 years) completed the survey. The majority were white (n=428; 86%) and married (n=358; 72%), with relapsing-remitting MS (n=323; 65%). Sleep quality ranged widely (mean=43.2; SD=3; range 27.9-59.9) with 90% reporting poor sleep. Pearson correlation results indicated a significant positive association between sleep quality and sleep promoting behaviors (r=.339) and negative associations with age (r=-234) and race (r=-.148). Multiple regression showed that sleep promoting behaviors and age statistically significantly predicted sleep quality (F(5,399) =15.51,p<.001,R2=.152). MS type, years passed since MS diagnoses and race did not add significantly to the prediction. Conclusion These findings suggest that poor sleep quality was strongly associated with sleep promoting behaviors among in older men with MS. Improving sleep promoting behaviors may substantially improve sleep quality. Further qualitative research is required to address the lack of information on understanding factors that disturb sleep among men with MS. Support (if any) This study was supported by National Heart, Lung, and Blood Institute (NHLBI) UB Clinical Scholar Program in Implementation Science to Achieve Triple Aims -NIH K12 Faculty Scholar Program in Implementation Science (NHLBI) Award

A Survey on Monitoring and Management of Cerebral Vasospasm and Delayed Cerebral Ischemia After Subarachnoid Hemorrhage: The Mantra Study.

Cerebral infarction from delayed cerebral ischemia (DCI) is a leading cause of poor neurological outcome after aneurysmal subarachnoid hemorrhage (aSAH). We performed an international clinical practice survey to identify monitoring and management strategies for cerebral vasospasm associated with DCI in aSAH patients requiring intensive care unit admission. The survey questionnaire was available on the European Society of Intensive Care Medicine (May 2021-June 2022) and Neurocritical Care Society (April - June 2022) websites following endorsement by these societies. There were 292 respondents from 240 centers in 38 countries. In conscious aSAH patients or those able to tolerate an interruption of sedation, neurological examination was the most frequently used diagnostic modality to detect delayed neurological deficits related to DCI caused by cerebral vasospasm (278 respondents, 95.2%), while in unconscious patients transcranial Doppler/cerebral ultrasound was most frequently used modality (200, 68.5%). Computed tomography angiography was mostly used to confirm the presence of vasospasm as a cause of DCI. Nimodipine was administered for DCI prophylaxis by the majority of the respondents (257, 88%), mostly by an enteral route (206, 71.3%). If there was a significant reduction in arterial blood pressure after nimodipine administration, a vasopressor was added and nimodipine dosage unchanged (131, 45.6%) or reduced (122, 42.5%). Induced hypertension was used by 244 (85%) respondents as first-line management of DCI related to vasospasm; 168 (59.6%) respondents used an intra-arterial procedure as second-line therapy. This survey demonstrated variability in monitoring and management strategies for DCI related to vasospasm after aSAH. These findings may be helpful in promoting educational programs and future research.

751 Burn Therapy Certified Therapists Representation within Burn Society Leadership

Abstract Introduction The American Burn Association (ABA) Burn Therapist Certification (BT-C) program, developed in 2018, derived from an organizational desire to promote vetted quality burn care across the interprofessional team. Leadership positions within organizations, are responsible for formulating policy, developing education, and providing oversite to ensure the success of the association. A previous study examining interdisciplinary representation within burn society leadership for the ABA and International Society of Burn Injuries, found that rehabilitation representation within governance positions was 7% and 9% within committee memberships. In a 2022 Letter to the Editor, therapists described limited center support as a barrier for obtaining BT-C. This study aims to examine BT-C member involvement within ABA society leadership. Methods Official ABA society and membership websites were accessed to identify BT-C recipients who currently hold positions within society governance and committee memberships. ABA Special Interest Group (SIG) membership was also examined. The Journal of Burn Care and Research (JBCR) website was accessed to identify BT-C recipients on the editorial board. BT-C members were compared to other therapist involvement. Results Of 32 qualified BT-C therapists, 26 continue their ABA memberships. BT-C therapists hold 3 Governance positions (Board membership and current ABA President) and maintain 36 of the available 77 committee positions (47%). Excluding the BT-C Committee from data collection, BT-C therapists make up 44% (n=23) of therapist committee positions within the ABA. BT-C therapists hold a combined 46 SIG memberships. The JBCR currently lists 2 therapists on the editorial board, both of whom are BT-C. Conclusions Despite representing a fraction of the burn therapy community, BT-C therapists continue to be leaders within the burn field by participation in ABA membership, governance, and committee memberships. Current BT-C therapists serve to establish standards in research published within the JBCR. Professional and academic societies depend on qualified leaders to set standards of burn care. Promoting BT-C within individual burn centers may stimulate leadership within the center and burn professional organizations. Applicability of Research to Practice Definitive evidence supporting the benefits of BT-C to individuals and organizations is needed to overcome current barriers to certification.

SIGnature Libraries: A roadmap for the formation of special interest group libraries.

"SIGnature Libraries" channel the dynamism of academic society-based special interest groups (SIG) to systematically identify and provide user-oriented access to essential literature for a subspecialty field in a manner that keeps pace with the field's continuing evolution. The libraries include literature beyond clinical trial data to encompass historical context, diagnostic conceptualization, and community organization materials to foster a holistic understanding of how neurologic conditions affect individuals, their community, and their lived experience. Utilizing a modified-Delphi approach, Child Neurology Society's Cerebral Palsy (CP) SIG (n = 75) administered two rounds of literature submissions and ratings. A final review by an 11-member international advisory group determined threshold ratings for resource inclusion and the library's final structure. Seventy-nine articles were submitted for the first Delphi round and 22 articles for the second Delphi round. Survey response rates among SIG members were 29/75 for the first round and 24/75 for the second round. The advisory board added additional articles in the final review process in view of the overall project goal. A total of 60 articles were included in the final library, and articles were divided into seven sections and stratified by rating scores. A process for ongoing revisions of the library was determined. The library will be published on the Child Neurology Society website and made publicly accessible. The CP SIGnature Library offers learners an unprecedented resource that provides equitable access to latest consensus guidelines, existing seminal datasets, up-to-date review articles, and other patient care tools. A distinctive feature of the library is its intentional large scope and depth, presented in a stratified fashion relative to the consensus-determined importance of each article. Learners can efficiently navigate the library based on individual interests and goals, and the library can be used as core curriculum for CP education.

Hereditary lung diseases and modern possibilities of genetic testing

The European Respiratory Society website gives the following criterion for the disease to be classified as rare (orphan) - the disease occurs in 1 person per 2 000. One of the well-studied rare lung diseases is cystic fibrosis (CF), which is often considered a medical care model for patients with other orphan diseases. However, effective diagnostics and therapies have not yet been developed for many other rare diseases. Moreover, their true prevalence remains unknown because these diseases often go undiagnosed. One of the problems in diagnosing rare diseases is the lack of knowledge among physicians.The aim of this review is to provide a brief clinical and genetic description of rare hereditary lung diseases and to show modern genetic diagnostics to raise awareness among physicians. Data from 95 articles on hereditary lung diseases were used.Results. The results of the analysis of lung diseases associated with bronchiectasis, fibrosis, pneumothorax, and hereditary storage diseases are presented. Genetics and diagnostics, including the three-step molecular genetic testing for cystic fibrosis, are considered in detail. The diagnosis has been developed for both neonatal screening and clinical manifestations. The emergence of targeted therapy based on genetic diagnosis makes neonatal screening even more relevant and leads to an increase in life expectancy. A patient registry was established within 10 years. A detailed analysis of the diagnosis of primary ciliary dyskinesia (PCD) is given, taking into account the absence of a single “golden” standard for the diagnosis of PCD. The genetic basis of the most common hereditary diseases and modern possibilities of their diagnosis are discussed, including sequencing of genes responsible for the development of orphan diseases using standard Sanger sequencing methods and next-generation sequencing, and creating multigene panels.Conclusion. New molecular diagnostic methods will help to understand the nature of orphan lung diseases, study their epidemiology, and develop new diagnostic algorithms. The study of the genetic causes of rare diseases may serve as a basis for the development of targeted therapy.

Remembering Ruth Milligan Ballweg, MPA, PA-C Emeritus.

Remembering Ruth Milligan Ballweg, MPA, PA-C Emeritus.

Women Representation in Anesthesiology Society Leadership Positions.

Although the number of women in medicine has increased, women remain underrepresented in leadership positions, specifically in medical societies. Specialty societies in medicine are influential in networking, career advancement, research and education opportunities, and providing awards and recognition. The goals of this study are to examine the representation of women in leadership positions in anesthesiology societies compared to women society members and women anesthesiologists and to analyze the trend in women society presidents over time. A list of anesthesiology societies was obtained from the American Society of Anesthesiology (ASA) website. Society leadership positions were obtained via the societies' websites. Gender was determined by images on the society website and images or pronouns on hospital websites and research databases. The percentage of women presidents, vice presidents/presidents-elect, secretaries/treasurers, board of directors/council members, and committee chairs was calculated. The percentage of women in society leadership positions was compared to the percentage of women society members when available, and the percentage of women anesthesiologists in the workforce (26%) using binomial difference of unpaired proportions tests. The trend of women presidents from 1980 to 2020 was analyzed using a Cochran-Armitage trend test. A total of 13 societies were included in this study. Overall, women held 32.6% (189/580) of leadership positions. 38.5% (5/13) of presidents, 17.6% (3/17) of presidents-elect/vice presidents, and 45% (9/20) of secretaries/treasurers were women. In addition, 30.0% (91/303) of board of directors/council members and 34.2% (90/263) of committee chairs were women. The percentage of women holding society leadership positions was significantly greater than the percentage of women anesthesiologists in the workforce ( P < .001), as was the percentage of women as committee chairs ( P = .003). The percentage of women society members was available for 9 of 13 societies (69%), and the percentage of women leaders was similar to the percentage of women society members ( P = .10). There was a significant difference in the percentage of women leaders between society size categories. Small societies had 32.9% (49/149) women leaders, medium had 39.4% (74/188) women leaders, and the single large society had 27.2% (66/243) ( P = .03). There were also significantly more women leaders in the Society of Cardiovascular Anesthesiologists (SCA) than there are women members ( P = .02). This study suggests that anesthesia societies may be more inclusive of women in leadership positions compared to other specialty societies. Although in anesthesiology, women remain underrepresented in academic leadership roles, there is a higher proportion of women in leadership roles in anesthesiology societies than proportion of women in the anesthesia workforce.

Updated on the Communications Society's Web Site

Updated on the Communications Society's Web Site

Demographics, Motivations, and Experiences of Participants in Transplantation or Cellular Therapy Fellowships

Recent American Society for Transplantation and Cellular Therapy guidelines have sought to establish clinical and research expectations for participants in blood and marrow transplantation (BMT) and cellular therapy (CT) fellowships. However, little is known about participants in BMT/CT fellowships and the value they find from this additional training. We wanted to characterize the demographics, motivations, and experiences of recent participants in BMT/CT fellowships. We developed a 27-item online survey addressing backgrounds, application processes, training experiences, and perceived benefits among physicians who had started a clinical U.S.-based BMT/CT fellowship between 2012 to 2021. Anonymous responses were solicited through program director outreach, society website postings, targeted emails, and social media. Of 105 respondents (44% pediatric trainees), 4% were URMs and 39% were non-U.S. IMGs. The most important motivations for applying were comfort with allogeneic BMT, improved career prospects, and opportunities for research and publication. Almost all respondents (92%) attended donor selection meetings, whereas smaller proportions visited cell processing facilities (65%), HLA laboratories (57%), or good manufacturing practice facilities (22%). Most respondents reported ≥1 publication (26% reported 4+) based on research or experiences during their fellowship. Respondents reported improved post-fellowship comfort with all queried BMT/CT-related competencies. Seventy percent of respondents stated that they would recommend their fellowship highly to others; this corresponded to a Net Promoter Score of +65%, consistent with a strongly positive experience. Most respondents reported currently being in clinical practice (89% at academic centers), with a median of 70% of time currently spent caring for BMT/CT recipients. Although limited by recruitment methods and recall bias, our study demonstrated that BMT/CT fellowships are effective at increasing comfort with BMT/CT management and that most participants would highly recommend this BMT/CT training to others. Nevertheless, our study identified substantial heterogeneity in clinical responsibilities and BMT/CT-related laboratory exposure. The high representation of non-U.S. IMGs underscores the distinct role of BMT/CT fellowships for this group, whereas improved URM recruitment remains an important future direction for the field. Whether advanced fellowships will ever become required for the future BMT/CT workforce, analogous to the additional training required for solid organ transplantation in other medical and pediatric subspecialties, remains uncertain.

Updated on the Communications Society's Web Site

Updated on the Communications Society's Web Site

On Welty and Ecology

On Welty and Ecology Sarah Gilbreath Ford (bio) Welty's love of nature probably manifests most directly in her love of gardening. A letter to Diarmuid Russell in 1942 contains a snapshot of this passion as Welty writes, "I have lots of energy and full days working, but on flowers, not stories—there is so much to do outside that I may never get through and never get to stories. I only think about the kind of day and the feel of the earth that day, and the planting and transplanting and spading and digging and weeding and watering, and then I am asleep and doing the same thing in my sleep" (Tell 55). Welty may have joked that she was just her mother's yard boy, but her love of gardening evident in this letter translates into a lifelong appreciation for the natural world, which, as Julia Eichelberger explains, was to Welty, "both a physical and a spiritual phenomenon" (xv). Welty's fiction consequently abounds with intricate descriptions of the environment, such as when Laura McRaven in Delta Wedding looks out of a train window and sees that the "land was perfectly flat and level but it shimmered like the wing of a lighted dragonfly. It seemed strummed, as though it were an instrument and something had touched it" (92), or when the couple heading south of New Orleans in "No Place for You, My Love" faces "[m]ore and more crayfish and other shell creatures litter[ing] their path, scuttling, or dragging" (565). Critics have, of course, discussed Welty's use of nature, from her careful delineation of place to her accurate placing of the moon in the right part of the sky. The current body of ecocritical theory now gives us new lenses to see how Welty crafts environments in her prose. The four essays in this Welty and Ecology cluster reveal how varied these tools can be. Jill Goad uses a framework of the anti-pastoral to read bodies of water and trees in The Golden Apples. Grace McCright uses ecogothic theory to posit that "Moon Lake" thwarts the human/nonhuman boundary. Nicole Salama uses a theory of the environment to read home as referring to landscape instead of a house in The Optimist's Daughter. And I read the vibrancy of the watery [End Page 59] world in Delta Wedding as enabling a new coming-of-age narrative. Using different theoretical contexts and analyzing different works, these four essays indicate that Welty's rapt attention to the natural world speaks perfectly to contemporary conversations about ecocriticism. Together, these four essays further reveal how reading the natural world in Welty's fiction allows insight into human character. We chose the word "ecology" for this cluster rather than "nature" or "environment" to highlight the relationship of the human to the natural world, the very thread Welty traces in all her works. When characters, such as Laura traveling to the Delta or the couple headed south, think about the land or the creatures around them, their descriptions reveal something of themselves. Laura finds the landscape magical because it connects her to her lost mother, while the couple notices the swarms of crayfish as a signal of their desire to adventure into an environment markedly different from their normal lives. We hope that these essays will spark more critics to try out ecocritical, ecofeminist, or ecogothic tools to see what other discoveries about nature, humans, and humans in nature may be in store. Sarah Gilbreath Ford Baylor University Sarah Gilbreath Ford SARAH GILBREATH FORD is professor of American literature at Baylor University and serves as the director of Baylor's Beall Poetry Festival. She is the author of Tracing Southern Storytelling in Black and White (2014) and Haunted Property: Slavery and the Gothic (2020). She serves as an associate editor of the Eudora Welty Review and as web editor of the Eudora Welty Society's website. In 2018 she won the Eudora Welty Society's Phoenix Award for scholarship and service. In 2019 she was named a Baylor Centennial Professor. WORKS CITED Eichelberger, Julia. "Introduction: Gardener, Friend, and Artist." Tell about Night Flowers: Eudora Welty's Gardening Letters, 1940...

From the Mast-Head

From the Mast-Head Brian Yothers We begin a new year and a new three-year cycle of Leviathan issues this spring. This new cycle for Leviathan corresponds with new terms for the leadership of The Melville Society as a whole, and I want to pause for a moment in this column to thank our Society leadership from the least three years, as this last three-year cycle has posed challenges of the sort that scholarly societies and journals do not routinely encounter, not least because of the fact that the COVID-19 pandemic has set the terms for our work in many ways since March of 2020. We have a great deal to celebrate as we begin our new cycle, from a highly successful conference in Paris that constitutes much of the subject matter for this issue to the fact that we are now celebrating our twenty-fifth anniversary as a journal, as indicated by the twenty-fifth anniversary logo on our cover designed by Karen Coughlin in consultation with Mary Alice Fallon Yeskey. The Melville Society has benefited immensely from the commitment of its officers and committee members, not only to keeping the Society going, but also to ensuring that the growth and development of the Society and journal continue. I want to begin by thanking our officers and committee members from the last three years. Our three presidents, Samuel Otter, Timothy Marr, and Rodrigo Lazo, have all helped to ensure the strength of the organization during the pandemic and have gone beyond the traditionally ceremonial role of president in their contributions to the flourishing of The Melville Society. Our Executive Secretary of the last three years, Matthew Rebhorn, faced the challenging situation of stepping into his role at the beginning of the pandemic and offering leadership to a Society that was only able to resume meeting in person in the middle of 2022. Our Associate Secretary for Programs and Conferences, Meredith Farmer, had instituted a travel grant program in 2019 that she not only maintained, but expanded during the pandemic years, greatly aiding scholars seeking to travel to our 2022 conference in Paris. Many senior members of the Society contributed generously to the travel grant program, enabling the conference to be as broadly inclusive as possible. Zachary Hutchins, our Treasurer for the last three years, also stepped into an unexpectedly challenging situation and responded with grace and determination in addressing the Society’s finances. Robert K. Wallace and Christopher Sten maintained a flourishing Melville Society Cultural Project throughout the pandemic years, laying [End Page 1] a foundation for continued contributions by the MSCP. Kelly Ross, our at-large member in the Executive Committee was consistently a sharp and thoughtful contributor to our discussions, as Jennifer Greiman, her predecessor in that role, moved on to doing superb work as Leviathan’s new Associate Editor. Our officers from 2020–2022 accomplished a great deal under inclement circumstances, as we redefined our relationship to Johns Hopkins University Press as a Member Society, reworked the Society’s dues structure, and commissioned the redesign of the Society website, all in the service of the continued flourishing of The Melville Society at a time when the humanities as a whole have often seemed under attack. We are excited to welcome our new Executive Committee members: John Wenke as President, Dawn Coleman as Executive Secretary, Steven Olsen-Smith as Treasurer (Society members may recall that Steve has served in this role before, and we are grateful for his return to the role), and Emilio Irigoyen as member-at-large. Robert K. Wallace, Meredith Farmer, Jennifer Greiman, and I will continue in our roles from the last three years, and we offer special thanks to Matthew Rebhorn, Zachary Hutchins, Christopher Sten, and Kelly Ross for their service to the Society over the last term. Our committees have also done important work over the last three years. Of particular note is the work that Carie Schneider has done as the chair of our Communications Committee and our new Web Editor in overseeing the updating and revamping of our website, and we are very grateful to Adam Fales, Chip Badley, and Kassie Jo Badon for their...

Cone-beam computed tomography use in postgraduate orthodontic programs in North America and Europe.

Cone-beam computed tomography (CBCT) has emerged over recent decades as a rapid acquisition technology that allows practitioners to view the craniofacial complex in high spatial detail. This study aimed to assess the latest trend of CBCT use in postgraduate orthodontic programs in North America and Europe/Australia. An electronic multiple-choice survey was sent via email requesting anonymous participation of postgraduate orthodontic program directors: 73 in North America (as listed on the American Association of Orthodontists website) and 189 in Europe/Australia (as listed on the European Orthodontic Society website). Survey collection was over a 2-month period with two follow-up emails sent 2 weeks and 1 month after the initial email to each program director who had not responded. Responses were collected directly on Qualtrics for analysis. The response rate was 46.6% (34 responses) for North America and 11.1% (21 responses) for Europe/Australia. Results revealed that 100% of respondents from North America had access to a CBCT scanner, while 90.48% of respondents (19 responses) from Europe/Australia had access. Most North American postgraduate orthodontic programs have CBCT scanners within their clinic, while most European/Australian programs do not, and they refer patients to the radiology department. Although there is a higher percentage of programs in North America compared to Europe/Australia that use CBCT as part of routine orthodontic records for all patients, most programs in both regions use CBCT imaging for specific diagnostic purposes and not for routine records. Overall, North American programs have more access to CBCT scanners in postgraduate clinics and use CBCT imaging more routinely than European/Australian programs.

Physician distress when treatments fail. Survey on physician distress when treating persons with drug-resistant epilepsy and knowledge of neuropalliative care

ObjectiveDrug-resistant epilepsy can be difficult to cure and may pose emotional challenges for epilepsy providers. Neuropalliative care (NPC) can augment quality of life (QOL) in persons with neurological diseases and may add meaningful elements to the treatment repertoire of epilepsy specialists even if seizures continue. However, NPC has not been widely implemented in epilepsy. Our study aimed to determine whether physicians of persons with drug-resistant epilepsy (PWDRE) experience distress when faced with treatment failure (Engel class ≥ 2), either failure of medications-only (PWDREmo) or of both medications and surgery (procedures with curative intent (PWDREms)). Furthermore, we evaluated physician knowledge about and referrals to NPC following treatment failures to help improve patient QOL despite ongoing seizures. MethodsAn anonymous online survey was distributed to US epilepsy physicians through the American Epilepsy Society website and personal email to assess levels of distress experienced when caring for PWDREmo and PWDREms (7-point Likert scale [“1” = “no distress”, “7” = “most distress ever felt”]), and knowledge and use of NPC. ResultsEighty-two physicians completed the survey. Most experienced distress when epilepsy treatments failed: 59% felt moderate distress (≥4) with PWDREmo (median “4”, mean 3.74, range 1–7), 90% suffered moderate to severe distress (5, 5.17, 1–7) with PWDREms. Distress over PWDREms was significantly greater than distress over PWDREmo (p < 0.0001). Forty-three percent reported confidence in their knowledge about NPC. Only 15% were likely to refer PWDREmo to NPC, while 44% would consider it for PWDREms. ConclusionAmong survey responders, physician distress was high when confronted with treatment failures, especially the failure of epilepsy surgery. Fewer than half of responders were likely to refer patients to NPC. Further research is necessary to determine extent, reasons, and effects of physician distress and whether improved understanding of and patient access to NPC would help alleviate physician distress when faced with treatment failures in PWDRE.

Dual voices, hybrid identities: the recontextualization of research in digital dissemination scientific discourse

The current demands placed on scientists to increase public awareness of their findings involves recontextualizing highly technical research to be understood by diversified audiences. In the present study, a corpus of 20 online digests drawn from the British Psychological Society website, which are condensed versions of recently published research articles, is quantitatively and qualitatively explored in terms of the (meta)discoursal features that the scriptwriter uses to foster comprehensibility, project a credible and authoritative voice and enhance engagement with their audience, as a way to bridge the existent knowledge asymmetries. The analysis revealed the existence of discoursal and pragmatic, as well as some multimodal, resources (i.e. code glosses, hyperlinking, evidentials, engagements markers) used by the scriptwriters to project a dual voice which aligns both with the expert and with the diversified audience, thus projecting a hybrid authorial identity.