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COVID-19 has caused increased stress among U.S. adults, with many reporting concerns assisting their children with distance learning due to school closures. This study surveyed U.S. parents--most of whom were middle-aged, White, affluent, and female--to learn what types of distance learning activities parents engaged in with their children during COVID-19; whether these types of activities varied by the child's age; and whether there was an association between engaging in these activities and stress. Most parents engaged in Monitoring, Teaching or Technology support activities with their children. Although these activities varied by child's age, parents who reported engaging in any distance learning activity reported increased stress.

BACKGROUND:Patients can present with symptomatic gallbladder disease after cholecystectomy due to a remnant gallbladder. This is a rare problem and challenging diagnosis with limited prior characterization; thus, we present a large series of patients with a gallbladder remnant. METHODS:A retrospective review was performed of all patients presenting with symptomatic gallbladder remnant at a tertiary care center from 2002 to 2016. Data on presenting symptoms, diagnostic tests, treatments, and follow-up were collected. RESULTS:Thirty-one patients diagnosed and treated for a symptomatic gallbladder remnant were identified. The most common presenting symptoms included right upper quadrant pain (87%) and nausea (55%). The median time from symptom presentation to definitive diagnosis was 60 days. Diagnostic modalities utilized in the evaluation of these patients demonstrated that endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography were effective with sensitivities of 85% and 90%, respectively. Twenty-three (76.2%) patients underwent completion cholecystectomy, which proved to be definitive treatment. Additionally, eight (25.8%) patients were non-operative candidates and underwent endoscopic retrograde cholangiopancreatography and sphincterotomy, three of whom developed recurrent symptoms. CONCLUSION:A symptomatic gallbladder remnant after cholecystectomy is infrequently seen; however, the diagnosis should be considered in patients with recurrent biliary symptoms after cholecystectomy. Completion cholecystectomy can be challenging but is highly effective for definitive treatment.

Simple Summary: Sarcomas refer to a broad group of rare tumors that develop from bone and soft tissue. Sarcoma diagnosis is challenging because of its rarity and complexity, leading to misdiagnosis and delays in diagnosis and access to appropriate therapy. Liposarcomas are a common form of sarcoma, and there are four subtypes of liposarcomas: well-differentiated liposarcoma/atypical lipomatous tumors, dedifferentiated liposarcoma, myxoid liposarcoma, and pleomorphic liposarcoma. Treatment options are limited for those diagnosed with liposarcoma. Currently, the mainstay of therapy for primary localized liposarcoma is surgical removal of the tumor. Radiotherapy is commonly used in extremity tumors before surgery but has unproven effectiveness in the retroperitoneum. Chemotherapy sensitivity varies by liposarcoma subtype, further complicating treatment. As such, limited conventional treatment options (e.g., radiotherapy or chemotherapy) remain substantial barriers to care. This review provides information about the epidemiology, pathology, and treatment options currently available for liposarcoma. Sarcomas are a heterogeneous group of neoplasms that develop from bone and soft tissue. Approximately 80% of sarcomas affect soft tissue, with liposarcoma being one of the most common types, accounting for approximately 13–20% of all soft-tissue sarcomas. Per the World Health Organization, liposarcoma can be broadly classified into four different subtypes based on histologic examination: well-differentiated liposarcoma (WDLS)/atypical lipomatous tumors (ALT), dedifferentiated liposarcoma (DDLS), myxoid liposarcoma (MLS), and pleomorphic liposarcoma (PLS). WDLS/ALT is the most common liposarcoma subtype, accounting for approximately 31–33% of liposarcomas; DDLS accounts for 20%; MLS accounts for 19%; and PLS, the least common subtype, represents 7–8% of liposarcomas. Sarcoma diagnosis is challenging because of its rarity, intrinsic complexity, and diagnostic technological complexity. Sarcomas are misdiagnosed in approximately 30% of cases, leading to delays in diagnosis and access to appropriate therapy and clinical trials. Furthermore, treatment options are limited for those diagnosed with liposarcoma. This review discusses the epidemiology, pathology, and treatment options currently available for liposarcoma. [ABSTRACT FROM AUTHOR]

Simple Summary: Sarcomas are a heterogeneous group of tumors that arise from mesenchymal tissue, including adipose, bone, cartilage, skeletal muscle, and smooth muscle. Because of their rarity, optimal treatment planning requires discussion among sarcoma-experienced subspecialists. Studies have shown that treatment guided by multidisciplinary tumor boards (MTBs) is associated with better compliance with clinical practice guidelines and, in some cases, increased survival. The role of radiologists in the MTB setting is valuable in assessing disease in patients with sarcoma; however, radiologists' recommendations may differ from the MTB's consensus. This study highlights the discordance between the disease assessment and the clinical recommendations provided by radiologists and MTBs and encourages all radiologists caring for patients with sarcoma to participate in MTBs to best align their interpretations with optimal clinical management and make multidisciplinary aligned recommendations whenever feasible. Multidisciplinary tumor boards (MTBs) facilitate decision-making among subspecialists in the care of oncology patients, but the mechanisms by which they enhance outcomes remain incompletely understood. Our aim was to measure the agreement between sarcoma MTBs and radiology reports' disease assessment and management recommendations. This single-center IRB-approved retrospective study evaluated cases presented at a weekly sarcoma MTB from 1 August 2020 to 31 July 2021. Cases without clinical notes, imaging studies, or radiology reports were excluded. The data collected included the patient's clinical status at the time of the MTB, the treatment response assessment by the MTB and radiologists (stable disease; partial response; complete response; progressive disease/recurrence), and the recommendations of the radiology reports and of the MTB. The agreement between the initial radiologist review and MTB on disease assessment and recommendations was analyzed using kappa statistics. In total, 283 cases met the inclusion criteria. Radiology reports provided recommendations in 34.3% of cases, which were adhered to by the ordering providers in 73.2% of cases. The agreement between MTBs and radiology reports was moderate in disease assessment (86.2% agreement; κ = 0.78; p < 0.0001) and negligible in recommendations (36% agreement; κ = 0.18; p < 0.0001). Radiologists were more likely to assign progressive disease/recurrence than MTBs (54.4% vs. 44.4%; p < 0.001) and to recommend short-term imaging follow-up more commonly than MTBs (46.4% vs. 21.7%; p < 0.001). At a tertiary care center, radiologists' isolated interpretations of imaging findings and management recommendations frequently differ from the MTB's consensus, reflecting the value of multidisciplinary discussions incorporating the patient's clinical status and the available treatment options into the final radiographic assessment. [ABSTRACT FROM AUTHOR]

Urban agriculture initiatives are on the rise, providing healthy food while teaching a land ethic to youth. In parallel, increasing numbers of university graduates are obtaining Extension work requiring the effective communication of science in a diverse, urban, low-income setting. This study evaluates a pilot service-learning program, the Community Food Security Scholars program, designed to teach students the complexities of urban food security issues while they acquire basic agriculture production skills. By analyzing student responses in pre- and post-service interviews, the authors evaluated students' interaction with the diverse and economically disadvantaged populations, with which many of the students had little previous experience. Results revealed that although students felt they gained valuable theoretical and experiential knowledge about food access, they also faced challenges interacting with community members, possibly affecting the project's learning outcomes. The evaluation resulted in a new course with enhanced opportunities for cultural competency training and outreach. (Contains 1 figure.)

This article reports on a study to determine which information sources organic growers use to inform farming practices by conducting in-depth semi-structured interviews with 23 organic farmers across 17 North Carolina counties. Effective information sources included: networking, agricultural organizations, universities, conferences, Extension, Web resources, personal experience, books, organic buyers/certifiers, and consultants. Results suggest that grower-to-grower networking is a highly effective information-seeking behavior for organic growers. Recommendations for Extension personnel include reshaping educational programing for organic growers to include peer-to-peer information sharing, as well as increased investment to graduate and undergraduate programs that train future Extension agents in organic production approaches.

This article describes a course that integrates environmental science students into local community organizations. Despite initially high expectations, students who completed the course held negative opinions about their experience because of inadequate community partner preparation. Based on the course's successes and challenges, in this article, the authors presents organizational and logistical recommendations for other instructors wishing to link their classrooms to community organizations. (Contains 1 figure.)

Two of the central concerns in Hardy studies are the unstable treatment of women in his novels and Hardy's peculiar relation to his audiences. In Tess of the d'Urbervilles, these [...]

The author responds to author Laurence Raw's interpretation of the film "A Double Life," directed by George Cukor. She comments on the failure of a person to adapt to changing realities and cultural shifts, as well as the dangers of narcissistic obsession and difficulties of avoiding the pitfalls of over-identification with roles outside the self. She considers the idea that adaptation as a socialization process could be a counter to the phenomenology of immersion.

Sets an argument about the treatment of Tess' character in Thomas Hardy's novel, Tess of the d'Urbervilles. Hardy's thematic identification of Tess in the novel; Points of view by male characters, by the narrator and by a hypothetical observer of Tess as an image.

The tumor microenvironment (TME) represents a significant barrier to creating effective therapies for metastatic colorectal cancer (mCRC). In several malignancies, bone marrow derived CCR2+ inflammatory monocytes (IM) are recruited to the TME by neoplastic cells, where they become immunosuppressive tumor associated macrophages (TAM). Here we report that mCRC expression of the chemokine CCL2 facilitates recruitment of CCR2+ IM from the bone marrow to the peripheral blood. Immune monitoring of circulating monocytes in patients with mCRC found this influx was a prognostic biomarker and correlated with worse clinical outcomes. At the metastatic site, mCRC liver tumors were heavily infiltrated by TAM, which displayed a robust ability to dampen endogenous anti-tumor lymphocyte activity. Using a murine model of mCRC that recapitulates these findings from human disease, we show that targeting CCR2 reduces TAM accumulation in liver metastasis and restores anti-tumor immunity. Additional quantitative analysis of hepatic metastatic tumor burden and treatment efficacy found that administration of a small molecule CCR2 inhibitor (CCR2i) improves chemotherapeutic responses and increases overall survival in mice with mCRC liver tumors. Our study suggests that targeting the CCL2/CCR2 chemokine axis decreases TAM at the metastatic site, disrupting the immunosuppressive TME and rendering mCRC susceptible to anti-tumor T-cell responses. [ABSTRACT FROM AUTHOR]

The author discusses the character of Carol White in the film "[Safe]" directed by Todd Haynes. She describes the character of White. She explains how reading "[Safe]" in juxtaposition to "The Yellow Wallpaper" helps illuminate the feminist spirit of the film. She believes Haynes is the ultimate Foucauldian social problem film director.

Reviews the motion picture "Safe," directed by Todd Haynes and starring Julianne Moore.