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Family communication, as an upper-level communication course, attracts communication majors and students studying in other disciplines. As such, instructors employ pedagogies that appeal to both majors and non-majors. This essay reflects on how I used project-based learning (PBL) in a family communication course filled with mostly non-majors. The essay highlights my rationale for choosing PBL, provides an explanation of the PBL activity, describes how PBL addresses two key problems I experienced in teaching the family communication course, and offers conclusions regarding lessons learned.

This article examines how the COVID-19 pandemic impacts five MotherScholars, mothers and scholars blending their maternal and academic identities, through the use of interactive interviewing, autoethnography, and narrative. The narratives are presented from four distinct times during the first 10-months of the COVID-19 pandemic: beginning (March through May of 2020), the middle (summer of 2020), the perpetuated middle (fall semester 2020), and present day (December 2020). The narratives capture how we, as five MotherScholars, negotiated between maternal and academic roles under pandemic conditions, ultimately unveiling our MotherScholar identity. The article concludes by drawing attention to the value of women colleagues and friendships for social support, the role of narratives to reshape family stories, and the impetus for institutions of higher education to assist MotherScholars.

The MotherScholar identity demonstrates tensions, subjectivities, pluralities, and embodiment of multiple identities exacerbated by the sheltering at home conditions of COVID-19, in which MotherScholars simultaneously enact maternal and professional roles. Drawing on Ellingson's work with crystalized approaches to qualitative research, this study layers photovoice with autoethnographic methods to produce both data and MotherScholar representations during the COVID-19 pandemic. Using Zoom to conduct three interactive interviews, the authors discussed their COVID-19 narratives and shared images and social media posts that represented their embodied experiences as MotherScholars. Narrative analysis of interactive transcripts and images demonstrate temporal, material, and emotional themes. Implications of this research expand and complicate constructions of the MotherScholar identity and curate a plurality of MotherScholar embodied voices in a period of time when both maternal and professional identities have a totalizing effect on women in academia.

Background We assessed efficacy and safety of endoscopic ultrasound-guided biliary drainage (EUS-BD) vs. endoscopic retrograde cholangiopancreatography (ERCP) as first-line intervention in malignant distal biliary obstruction (MDBO). Methods PubMed/Medline, Embase, and Cochrane databases were searched until 01 /12 /2023 for randomized controlled trials of EUS-BD vs. ERCP for primary biliary drainage in patients with inoperable MDBO. The primary outcome was technical success. Secondary outcomes were clinical success, adverse events, mean procedure time, 1-year stent patency, and overall survival. Relative risk (RR) with 95 %CI were calculated using a random effects model. Results Five studies (519 patients) were included. RR (95 %CI) for EUS-BD was 1.06 (0.96 to 1.17; P = 0.27) for pooled technical success and 1.02 (0.97 to 1.08; P = 0.45) for clinical success. 1-year stent patency was similar between the groups (RR 1.15, 0.94 to 1.42; P = 0.17), with lower reintervention with EUS-BD (RR 0.58, 0.37 to 0.9; P = 0.01). The RR was 0.85 (0.49 to 1.46; P = 0.55) for adverse events and 0.97 (0.10 to 0.17; P = 0.98) for severe adverse events. On subgroup analysis, EUS-guided placement of lumen-apposing metal stent (LAMS) outperformed ERCP in terms of technical success (RR 1.17, 1.01 to 1.35; P = 0.03). Procedure time was lower with EUS-BD (standardized mean difference –2.36 minutes [–2.68 to –2.05; P < 0.001]). Conclusions EUS-BD showed a statistically significant lower reintervention rate than ERCP, but with similar technical success, stent patency, clinical success, and safety. Technical success of EUS-BD with LAMS was better than ERCP. [ABSTRACT FROM AUTHOR]

Pancreatic or peri pancreatic collections are the most frequent complication of acute pancreatitis. To make the difference between acute edematous and necrotic pancreatitis is crucial to choose the optimal therapeutic approach. Since the Atlanta classification, the different types of collections are well defined. During the first 4 weeks after acute pancreatitis onset, the pancreatic fluid collections (no clear wall, frequently related to an acute edematous pancreatitis with a spontaneously good evolution in most cases) and acute necrotic collections (with a variable solid component and frequently related to an acute necrotic pancreatitis) have been described. After 4 weeks, pancreatic pseudocysts (well-defined liquid collection with no solid component) and Walled-Off Necrosis (or WON, a capsulated collection with solid component) can be found. In 50% of cases, pancreatic collections (pseudocyst or WON) spontaneously disappear, without the need for drainage. Morphological follow-up is therefore recommended. Only symptomatic collections presenting with compression of a neighboring organ (stomach, duodenum, biliary tract), or infection of necrosis need drainage. Endoscopic route should be preferred if they are accessible. The modalities of drainage are based on a minimally invasive approach (called "step-up") as follows: cystostomy under endoscopic ultrasound guidance by metal (lumen-apposing metal stents) or plastic stents (double pigtail design), combined with endoscopic necrosectomy if necessary. Radiological and/or surgical drainage are sometimes necessary, particularly for collections not accessible by endoscopy (parieto-colic gutter, pelvis). [ABSTRACT FROM AUTHOR]

Intrahepatic cholangiocarcinoma (iCCA) is the second most common malignant primary liver cancer. iCCA may develop on an underlying chronic liver disease and its incidence is growing in relation with the epidemics of obesity and metabolic diseases. In contrast, perihilar cholangiocarcinoma (pCCA) may follow a history of chronic inflammatory diseases of the biliary tract. The initial management of CCAs is often complex and requires multidisciplinary expertise. The French Association for the Study of the Liver wished to organize guidelines in order to summarize the best evidence available about several key points in iCCA and pCCA. These guidelines have been elaborated based on the level of evidence available in the literature and each recommendation has been analysed, discussed and voted by the panel of experts. They describe the epidemiology of CCA as well as how patients with iCCA or pCCA should be managed from diagnosis to treatment. The most recent developments of personalized medicine and use of targeted therapies are also highlighted. [ABSTRACT FROM AUTHOR]

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Author(s): Jacques Boutros [sup.1], Sarah Leblanc [sup.2], Frédéric Pène [sup.1] [sup.3] Author Affiliations: (1) 0000 0001 0274 3893, grid.411784.f, Medical ICU, Cochin Hospital, Hôpitaux Universitaires Paris-Centre, Assistance Publique-Hôpitaux de Paris, [...]

Large flat colorectal polyps are often encountered during screening colonoscopies. The most frequently used approach for resecting these polyps is endoscopic mucosal resection, which is associated with a substantial rate of recurrent or residual adenoma, necessitating routine follow-up colonoscopy within months. An alternative endoscopic resection technique, endoscopic submucosal dissection, may enable en bloc resection of such polyps, potentially reducing the rate of recurrent or residual adenoma. This randomized controlled trial compared these 2 endoscopic resection techniques in terms of the rate of neoplastic local recurrence during the 6-month follow-up colonoscopy. Visual Abstract. Endoscopic En Bloc Versus Piecemeal Resection of Large Nonpedunculated Colonic Adenomas: Large flat colorectal polyps are often encountered during screening colonoscopies. The most frequently used approach for resecting these polyps is endoscopic mucosal resection, which is associated with a substantial rate of recurrent or residual adenoma, necessitating routine follow-up colonoscopy within months. An alternative endoscopic resection technique, endoscopic submucosal dissection, may enable en bloc resection of such polyps, potentially reducing the rate of recurrent or residual adenoma. This randomized controlled trial compared these 2 endoscopic resection techniques in terms of the rate of neoplastic local recurrence during the 6-month follow-up colonoscopy. Background: Endoscopic resection of adenomas prevents colorectal cancer, but the optimal technique for larger lesions is controversial. Piecemeal endoscopic mucosal resection (EMR) has a low adverse event (AE) rate but a variable recurrence rate necessitating early follow-up. Endoscopic submucosal dissection (ESD) can reduce recurrence but may increase AEs. Objective: To compare ESD and EMR for large colonic adenomas. Design: Participant-masked, parallel-group, superiority, randomized controlled trial. (ClinicalTrials.gov: NCT03962868) Setting: Multicenter study involving 6 French referral centers from November 2019 to February 2021. Participants: Patients with large (≥25 mm) benign colonic lesions referred for resection. Intervention: The patients were randomly assigned by computer 1:1 (stratification by lesion location and center) to ESD or EMR. Measurements: The primary end point was 6-month local recurrence (neoplastic tissue on endoscopic assessment and scar biopsy). The secondary end points were technical failure, en bloc R0 resection, and cumulative AEs. Results: In total, 360 patients were randomly assigned to ESD (n  = 178) or EMR (n  = 182). In the primary analysis set (n  = 318 lesions in 318 patients), recurrence occurred after 1 of 161 ESDs (0.6%) and 8 of 157 EMRs (5.1%) (relative risk, 0.12 [95% CI, 0.01 to 0.96]). No recurrence occurred in R0-resected cases (90%) after ESD. The AEs occurred more often after ESD than EMR (35.6% vs. 24.5%, respectively; relative risk, 1.4 [CI, 1.0 to 2.0]). Limitation: Procedures were performed under general anesthesia during hospitalization in accordance with the French health system. Conclusion: Compared with EMR, ESD reduces the 6-month recurrence rate, obviating the need for systematic early follow-up colonoscopy at the cost of more AEs. Primary Funding Source: French Ministry of Health. [ABSTRACT FROM AUTHOR]